MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'better health'. Sat, 03 Sep 2011 02:11:24 +0100 http://www.medworm.com/index.php?rid=5174614&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-beneficial-effect-of-laughter-on-your-health%2F2011.08.29 I stumbled upon the article ‘Laughter: gender-specific variations’ in Revista Clínica Española (‘Spanish Clinical Journal’) and I can’t help thinking about the need for taking this into account to improve doctor-patient relationships. The text can actually be read as a guide to understand how every person laughs and how to use it in clinical practice. Table 1. Laughter effect on health (more…) *This blog post was originally published at Diario Medico* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5174614 Mon, 29 Aug 2011 14:00:27 +0100 5174614 http://www.medworm.com/index.php?rid=5174617&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-history-found-to-be-key-element-in-making-a-diagnosis%2F2011.08.28 Four out of five doctors agree that they don’t need scans to make the right diagnosis. It’s an old-fashioned concept frequently discussed among ACP members, but the history and physical combined with basic tests is way more important to diagnosis than ordering scans and advanced tests. A recent research letter in the Archives of Internal Medicine makes the case. In the letter, Israeli researchers described a prospective study of 442 consecutive patients admitted from the emergency department in 53 days. A senior resident examined all patients within 24 hours of admission (mean=14), including a history, physical, and review of ancillary test findings done at the emergency department, such as blood and urine tests, electrocardiography, and chest radiography. The resident also rev... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174617 Sun, 28 Aug 2011 18:30:00 +0100 5174617 http://www.medworm.com/index.php?rid=5077687&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsurgeons-have-a-bad-reputation%2F2011.07.29 This article is meant to raise the awareness of the costs—both in dollars and in human misery—of incivility in the practice of medicine by looking in particular at the case of surgeons. Uncivil behavior brings misery wherever it occurs.  If the individual tends to behave in an uncivil fashion prior to medical school and prior to residency, (more…) *This blog post was originally published at Suture for a Living* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5077687 Fri, 29 Jul 2011 14:00:00 +0100 5077687 http://www.medworm.com/index.php?rid=4984446&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-centers-for-disease-control-and-prevention-cdc-bloggers-join-the-better-health-team%2F2011.06.30 It is with great pleasure that I welcome our CDC colleagues to the Better Health blog team. Going forward, Better Health will feature content from the CDC blogs on a weekly basis, and our collaborative efforts will be highlighted on the CDC blog pages as appropriate. Better Health and the CDC share a common mission: to reach as many Americans as possible with scientifically accurate, trustworthy, and helpful medical information. As social media platforms (such as blogs, Twitter, and Facebook) become a gathering place for people seeking health information – it is important for experts to be able to provide content through these channels. The CDC’s relationship with Better Health is an excellent example of a public-private partnership that can magnify reach and relevance. By beco... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984446 Thu, 30 Jun 2011 14:00:47 +0100 4984446 http://www.medworm.com/index.php?rid=4911546&cid=t_136248_106_f&fid=36682&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSutureForALiving%2F%7E3%2F_9xfbCf75y0%2Fimagine.html As you may know, I sew.   I grew up sewing many of my own clothes.  Now it’s mostly quilts, but I still occasional make an item of clothing. It’s always fun to imagine how a certain pattern would work on the intended person (me, a friend, a niece, etc), how it would look in this fabric, this color, this print. Always fun to imagine where you might wear the new dress, the new shirt, the new skirt.  Always fun to imagine how you might accessorize it.  Imagine the new shoes you might need. Burda has a sewing blog I follow.  Yesterday one of their posts was title:  6 New Patterns in Sizes 44-52.  I was hopeful the featured models would be the same sizes.  They didn’t.  (photo credit) Even worse, the models aren’t even shown wearing ... Suture for a Living blogs http://www.medworm.com/rss/comments.php?id=4911546 Wed, 08 Jun 2011 11:15:01 +0100 4911546 http://www.medworm.com/index.php?rid=4753759&cid=t_136248_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F04%2F25%2Funderstanding-research-an-interview-with-mark-young%2F Mark Young specializes in helping individuals learn to understand scientific research.  He has a degree in kinesiology with a minor in psychology from McMaster University in Canada, and he has conducted graduate research in biomechanics and exercise physiology under the guidance of Dr. Stuart Phillips.  Today, he’s an Ontario-based exercise and nutrition consultant. Here are some of Young’s thoughts about how we can understand research better. Correlation and causation are often confused.  How do we clear up the confusion when informing the lay public of this misunderstanding? Given the large amount of research presented to the lay public through the media I honestly think that everyone should be required to take at least one statistics and research design course in high sch... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4753759 Mon, 25 Apr 2011 19:46:15 +0100 4753759 http://www.medworm.com/index.php?rid=4704661&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fguidance-for-parents-how-to-raise-kids-in-the-internet-age%2F2011.04.11 As many who were children before the era of cell phones will remember, contacting a friend by phone often involved mastering at least the following script: “Hi, Mrs. Doe. Is Johnny home?” Not so today, in the world of cell phones, texting, email, Facebook, and Twitter. If you are a parent and don’t use or understand the new technologies, the American Academy of Pediatrics (AAP) has just issued a guideline saying that you probably should. More than half of teens connect to a social media site at least daily. Three-quarters have cell phones that they can use for social networking as well as texting. In a guideline published in March, the AAP makes the important (if obvious) point that today’s children are growing up on the Internet. Since children and adolescents now spend a great de... Better Health blogs http://www.medworm.com/rss/comments.php?id=4704661 Mon, 11 Apr 2011 23:00:19 +0100 4704661 http://www.medworm.com/index.php?rid=4600536&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fobesity-beats-adiposity-for-cardiovascular-risk%2F2011.03.16 Obesity contributes to cardiovascular risk no matter where a person carries the weight, concluded researchers after looking at outcomes for nearly a quarter-million people worldwide. Body mass index, (BMI) waist circumference, and waist-to-hip ratio do not predict cardiovascular disease risk any better when physicians recorded systolic blood pressure, history of diabetes and cholesterol levels, researchers reported in The Lancet. The research group used individual records from 58 prospective studies with at least one year of follow up. In each study, participants were not selected on the basis of having previous vascular disease. Each study provided baseline for weight, height, and waist and hip circumference. Cause-specific mortality or vascular morbidity were recorded according to well d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4600536 Wed, 16 Mar 2011 17:00:00 +0100 4600536 http://www.medworm.com/index.php?rid=4592393&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcavernous-angiomas-screening-of-a-family-over-three-generations%2F2011.03.15 Cavernous angiomas belong to a group of intracranial vascular malformations that are developmental malformations of the vascular bed. These congenital abnormal vascular connections frequently enlarge over time. The lesions can occur on a familial basis. Patients may be asymptomatic, although they often present with headaches, seizures, or small parenchymal hemorrhages. In most patients, cavernous angiomas are solitary and asymptomatic. In recent times, increasing MRI has detected several such asymptomatic cases and has prompted a study into the genetics and natural history of this condition. It is now known that cavernous angiomas have a genetic basis. Familial forms of cavernous angiomas are associated with a set of genes called CCM genes (cerebral cavernous angioma). This is a case repor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592393 Tue, 15 Mar 2011 20:00:02 +0100 4592393 http://www.medworm.com/index.php?rid=4592395&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-social-media-guide-for-researchers%2F2011.03.15 I’ve recently come across a great guide about using social media in science. I cover this issue in my university course, Internet in Medicine, and I’ll definitely update my materials with these suggestions. From the Research Information Network: This guide has been produced by the [University of Derby] International Centre for Guidance Studies (iCeGS), and aims to provide the information needed to make an informed decision about using social media and select from the vast range of tools that are available. One of the most important things that researchers do is to find, use and disseminate information, and social media offers a range of tools which can facilitate this. The guide discusses the use of social media for research and academic purposes and will not be examining the many... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592395 Tue, 15 Mar 2011 16:00:09 +0100 4592395 http://www.medworm.com/index.php?rid=4592396&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcall-for-submissions-grand-rounds-at-better-health%2F2011.03.15 Grand Rounds will be hosted right here at “home” at Better Health on Tuesday, March 22th, 2011. Please send your blog-post submissions via e-mail by 12:00AM midnight CT on Saturday, March 19th, to: maria.gifford@getbetterhealth.com. Please include:  ”Submission for Grand Rounds” in the subject line of your e-mail. Your name (blog author), the name of your blog, and the URL of your specific blog-post submission. A short summary (1 to 3 sentences) of your blog post. There’s no specific theme for this edition of Grand Rounds — just send us something really smart or deep or profound that will move us and make us all think harder about health and medicine. For more information, please see the Grand Rounds Submissions Guidelines. We look forward to ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592396 Tue, 15 Mar 2011 13:00:36 +0100 4592396 http://www.medworm.com/index.php?rid=4592397&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftalk-is-cheap-unless-its-talk-therapy%2F2011.03.14 Gardiner Harris had a [recent] article in the New York Times called “Talk Doesn’t Pay So Psychiatrists Turn to Drug Therapy.” The article is a twist on an old Shrink Rap topic, “Why your Shrink Doesn’t Take Your Insurance.” Only in this article the shrink does take your insurance, he just doesn’t talk to you. With his life and second marriage falling apart, a man said he needed help. But the psychiatrist, Dr. Donald Levin, stopped him and said: “Hold it. I’m not your therapist. I could adjust your medications, but I don’t think that’s appropriate.” Dr. Levin sees 40 patients a day. And he’ss 68 years old. This guy is amazing. There’s no way I could see 40 patients a day for even one day. He’s worried about his retireme... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592397 Mon, 14 Mar 2011 21:00:00 +0100 4592397 http://www.medworm.com/index.php?rid=4592401&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnearly-12-million-cancer-survivors-in-the-u-s%2F2011.03.14 The number of cancer survivors in the United States increased to 11.7 million in 2007, according to a report released by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Women survive more often, and survive longer, according to the report. There were 3 million cancer survivors in 1971 and 9.8 million in 2001. Researchers attributed longer survival to a growing aging population, early detection, improved diagnostic methods, more effective treatment and improved clinical follow-up after treatment. The study, “Cancer Survivors in the United States, 2007,” is published today in the CDC’s Morbidity and Mortality Weekly Report. To determine the number of survivors, the authors analyze... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592401 Mon, 14 Mar 2011 13:00:00 +0100 4592401 http://www.medworm.com/index.php?rid=4580893&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpregnant-women-and-exposure-to-paint%2F2011.03.13 I came across an article the other day about paint and pregnancy. Yes, that paint — the kind that you put on a canvas or slap on your walls. Did you know that paint is made of pigment particles in a liquid base called a medium? Oil paints are thinned or cleaned with paint thinners. Latex paints are thinned or cleaned with water. Most paint that’s used in the home is latex. Can environmental forces affected pregnancy? The short answer is “yes,” according to the Organization of Teratology Information Specialists (OTIS), whose mission is to study malformations of the unborn. Regarding paint and pregnancy, the amount of exposure is important. A one-time household exposure causes fewer problems than ongoing exposure through a work setting. And there have been medical stu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4580893 Sun, 13 Mar 2011 22:00:06 +0100 4580893 http://www.medworm.com/index.php?rid=4580894&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-i-want-her-to-know-about-diabetes%2F2011.03.13 After a tough low this morning: I want her to know that she was wanted so much, well before she arrived, and that her parents went to great lengths to make sure her arrival was as safe as they could manage. I want her to know that those moments when she has to wait while I test, or while I bolus, or the times when I have to set her in her crib and gulp down grape juice while she stands there with her big, brown eyes staring at me while her mouth tugs into an impatient smile, that I love her and I just need to deal with diabetes for a few seconds so I can be the best mommy I can. I want her to know that if my eyes don’t get better, it’s not her fault. It’s not my fault, either. The fault lies with diabetes. I want her to know that the reason I’ll sometimes frown at... Better Health blogs http://www.medworm.com/rss/comments.php?id=4580894 Sun, 13 Mar 2011 19:00:34 +0100 4580894 http://www.medworm.com/index.php?rid=4580895&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fanesthesia-medications-automatically-delivered-during-surgery%2F2011.03.13 A team of French anesthesiologists has developed an automatic delivery system of propofol and remifentanil, which they recently tested in a multi-center trial involving 196 surgical patients. The researchers reported in Anesthesia & Analgesia that the system, which uses a Bispectral Index (BIS) monitor as a guide, performed better than manual administration: We have developed a proportional-integral-derivative controller allowing the closed-loop coadministration of propofol and remifentanil, guided by a Bispectral Index (BIS) monitor, during induction and maintenance of general anesthesia. The controller was compared with manual target-controlled infusion. The controller allows the automated delivery of propofol and remifentanil and maintains BIS values in predetermined boundaries duri... Better Health blogs http://www.medworm.com/rss/comments.php?id=4580895 Sun, 13 Mar 2011 16:00:28 +0100 4580895 http://www.medworm.com/index.php?rid=4577906&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fred-light-cameras-save-lives%2F2011.03.12 Most people don’t like them. Privacy advocates abhor them. But, really– how many things can you name that save lives AND generate revenues for cash-strapped local and state governments? Red-light cameras are one such item. A recent study by the Insurance Institute for Highway Safety has shown that red-light cameras saved 159 lives over a four-year period in the 14 large U.S. cities where the study took place. The scientists claimed that more than 800 traffic fatalities would have been prevented during the course of the study if the cameras had been deployed in all large U.S. cities. The scientists compared fatal car crash rates in U.S. cities with populations of at least 200,000 for two four-year periods: 1992 to 1996 and 2004 to 2008. They excluded cities that had already deploy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4577906 Sat, 12 Mar 2011 15:00:34 +0100 4577906 http://www.medworm.com/index.php?rid=4575058&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbad-medical-marketing-an-ad-the-fda-should-pull%2F2011.03.11 If ever a medical device company crossed a line with their marketing, this one has. Essure, which makes a sterilization device for women, is trying to scare men away from vasectomy in order to drive women to use their device. “We made men watch footage of an actual vasectomy,” says the female voiceover — and then they proceed to show men’s reactions to watching a surgical procedure, with “That’s frickin’ gross, man” being the most memorable quote. The final tagline: “You can only wait so long for him to man up.” Yeah, and to be sure he doesn’t, they’ve created this ad. The ad is slimy, harmful, obnoxious, and just plain stupid. A couple’s decision as to which sterilization procedure is best for them should be one informed by real information, not f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4575058 Fri, 11 Mar 2011 16:00:26 +0100 4575058 http://www.medworm.com/index.php?rid=4570548&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F5-avoidable-air-travel-health-risks%2F2011.03.10 For those of you planning air travel to your next medical conference (and ACP Internist isn’t too shameless to plug Internal Medicine 2011 — we hope to see you there), TIME reports that there are five health risks that are rare yet have recently happened. Tips on avoiding these maladies include: – E. Coli and MRSA on the tray table. Microbiologists found these two everywhere when they swabbed down flights. Bring your own disinfecting wipes. – Bedbugs in the seat. British Airways fumigated two planes after a passenger posted pictures online about her experience. Wrap clothes in plastic and wash them. – Sick seatmates. Everyone has experienced (or been) this person. Wash your hands. – Deep vein thrombosis (DVT). Tennis star Serena Williams experienced a p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4570548 Thu, 10 Mar 2011 14:00:00 +0100 4570548 http://www.medworm.com/index.php?rid=4565902&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fniche-science-and-targeted-medicines-vs-magic-bullets%2F2011.03.09 Maybe you read the other day in The New York Times that the pharmaceutical industry has a problem. Big blockbuster drugs like Lipitor are going off patent and the industry leaders don’t have new blockbusters showing promise to replace them. So the big companies search for little companies with new discoveries and they consider buying them. Industry observers think the days of $5 billion-a-year drugs to lower cholesterol or control diabetes may be past for awhile, and the companies will have smaller hits with new compounds for autoimmune conditions and cancer. When I saw my oncologist for a checkup yesterday — the news was good — we chatted about the article and the trend toward “niche science.” We welcomed it. We didn’t think — from our perspective — the wor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4565902 Wed, 09 Mar 2011 22:30:58 +0100 4565902 http://www.medworm.com/index.php?rid=4565903&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmanaging-patient-uncertainty%2F2011.03.09 How comfortable are we with uncertainty? I struggle with this question every day. I treat children with abdominal pain. Some of these children suffer with crohns disease, eosinophilic esophagitis, and other serious problems. Some children struggle with abdominal pain from anxiety or social concerns. I see all kinds. But kids are tricky, and sometimes I can’t pinpoint the problem. Trudging forward with more testing is often the simplest option since it involves little thinking. And some parents perceive endless testing as “thorough.” The question ultimately becomes: When do we stop? Once we’ve taken a sensible first approach to a child’s problem and judged that the likelihood of serious pathology is slim, when and how do we suggest that we wait before going any furt... Better Health blogs http://www.medworm.com/rss/comments.php?id=4565903 Wed, 09 Mar 2011 20:30:46 +0100 4565903 http://www.medworm.com/index.php?rid=4560270&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fidentifying-skin-cancer-with-light%2F2011.03.08 Duke University scientists have been successfully testing a new laser system they developed to identify cancerous skin moles. Two lasers in the system are used to identify the presence of eumelanin in biopsy slices and a future version of the device may work directly without having to sample the mole. According to an article in Science Translational Medicine, “the ratio of eumelanin to pheomelanin captured all investigated melanomas but excluded three-quarters of dysplastic nevi and all benign dermal nevi.” From the press release: The tool probes skin cells using two lasers to pump small amounts of energy, less than that of a laser pointer, into a suspicious mole. Scientists analyze the way the energy redistributes in the skin cells to pinpoint the microscopic locations of diff... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560270 Tue, 08 Mar 2011 20:00:42 +0100 4560270 http://www.medworm.com/index.php?rid=4554608&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftravelers-diarrhea-the-basics%2F2011.03.06 This is a guest post by Dr. Erik McLaughlin. ********** Traveler’s Diarrhea: The Basics Known around the world by many names including “Montezuma’s revenge,” “Delhi belly” and “mummy tummy,” traveler’s diarrhea (TD) is the most common illness faced by travelers. Nothing can slow down a fun trip as easily as TD — and it can also have serious health implications. TD typically lasts four to six days, and 90 percent of cases occur within the first two weeks of travel. Anatomy You Need to Know The gastrointestinal tract starts at the mouth and ends at the anus. After food enters the mouth, it passes through the esophagus to the stomach, where it sits for approximately 45 minutes. After being broken down by gastric secretions, food matter enters the small intestine (d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4554608 Sun, 06 Mar 2011 13:00:00 +0100 4554608 http://www.medworm.com/index.php?rid=4544969&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpostpartum-hemorrhage-what-every-pregnant-woman-should-know%2F2011.03.03 Having a baby can be a beautiful thing until something goes wrong. The tragedy is that many high-risk conditions can be managed appropriately if the patient is cooperative and the healthcare provider is competent and well trained. Unfortunately, almost 600 pregnant women die in the U.S. each year from complications and the most common complication is significant blood loss after birth or postpartum hemorrhage (PPH).  PPH occurs when there is a blood loss of 500 cc or greater for a vaginal delivery and 1,000 cc after a cesarean section (C-section). Or, if you were admitted with a hemoglobin of 12 and it drops by ten points to 11, there should be a high index of suspicion for PPH as well. Therefore, if you feel lightheaded or dizzy, have palpitations or an increased heart rate after deliver... Better Health blogs http://www.medworm.com/rss/comments.php?id=4544969 Thu, 03 Mar 2011 18:00:52 +0100 4544969 http://www.medworm.com/index.php?rid=4540564&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fit%25e2%2580%2599s-time-to-tango-impatient-with-progress-on-patient-physician-partnership%2F2011.03.02 The other day I came across this photo of a couple clasping each other in a dramatic tango on the cover of an old medical journal – a special issue from 1999 that was focused entirely on doctor-patient partnership. The tone and subjects of the articles, letters and editorials were identical to those written today on the topic: “It’s time for the paternalism of the relationship between doctors and patients to be transformed into a partnership;” “There are benefits to this change and dangers to maintaining the status quo;” “Some doctors and patients resist the change and some embrace it: Why?” Two questions struck me as I impatiently scanned the articles from 12 years ago: First, why are these articles about doctor-patient partnership still so relevant? And second, why ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4540564 Wed, 02 Mar 2011 22:00:43 +0100 4540564 http://www.medworm.com/index.php?rid=4540565&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-science-should-override-celebrity%2F2011.03.02 Dr. Barron Lerner has written a book about breast cancer: “The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America.” And he’s written a book about celebrity patients: “When Illness Goes Public: Celebrity Patients and How We Look at Medicine.” He wed the two topics in a blog post on the New York Times health blog entitled “Suzanne Somers, Cancer Expert.” Excerpts: “Earlier this week, NBC’s “Dateline” devoted an entire hour on Sunday evening to allow the actress Suzanne Somers to express her rather unconventional beliefs about cancer. It is not the first time a major media outlet has given air time to Ms. Somers, whose journey into the medical realm has been featured on a variety of news prog... Better Health blogs http://www.medworm.com/rss/comments.php?id=4540565 Wed, 02 Mar 2011 20:00:58 +0100 4540565 http://www.medworm.com/index.php?rid=4536062&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdetecting-circulating-tumor-cells-with-gold-nanoparticles%2F2011.03.02 Our modern armamentarium for treating cancer is impressive, but sometimes, despite our best treatments, tumor cells continue to lurk in the bloodstream, seeding metastases throughout the body. Researchers at Emory have developed a way to monitor for these circulating tumor cells using gold nanoparticles. This technique has been used before, but difficulty was encountered because white blood cells are close to the same size as some tumor cells, so they would both be tagged, necessitating a laborious multi-antibody staining process. “The key technological advance here is our finding that polymer-coated gold nanoparticles that are conjugated with low molecular weight peptides such as EGF are much less sticky than particles conjugated to whole antibodies,” says Shuming Nie, Ph.D., a profes... Better Health blogs http://www.medworm.com/rss/comments.php?id=4536062 Wed, 02 Mar 2011 14:00:03 +0100 4536062 http://www.medworm.com/index.php?rid=4527733&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fweight-loss-counseling-is-race-a-factor%2F2011.02.27 Most people know that the U.S. is struggling to contain a surging epidemic of obesity, and that the problem is most acute among African-Americans. Whereas about 27 percent of all adult Americans are obese (defined as having a body mass index of 30 or more), fully 37 percent of African-American adults are obese, and that number jumps to an appalling 42 percent among African-American women. Over the years, public health officials have provided evidence that socioeconomic and cultural factors drive this racial disparity. Now, a new study suggests there is another reason as well: Obese African-Americans receive less obesity-related counseling than their white counterparts, and it matters not whether the physicians they see are African-American or white. To reach these conclusions, Sara Ble... Better Health blogs http://www.medworm.com/rss/comments.php?id=4527733 Sun, 27 Feb 2011 21:00:02 +0100 4527733 http://www.medworm.com/index.php?rid=4527734&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fquestioning-mobile-health%2F2011.02.27 This is something. Jay Parkinson on the Future Well blog has suggested that health apps are overrated. Then on Twitter came a remark that the post represented “fightin’ words.” While I think the tweet was in jest, I’m sure there are some who will take offense to the less-than-flattering remarks about our coveted health apps. We love the concept of health apps for what they represent more than for what they really offer us. We want to feel that we’ve got it all in the palm of our hand. After all, technology might do for us what we won’t do for ourselves. Like Jay I’m underwhelmed, but I don’t think that’ll always be the case. The post’s criticism should start a conversation about what’s real in mobile health and what isn’t. Even the fantasy of Health 2.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4527734 Sun, 27 Feb 2011 18:00:47 +0100 4527734 http://www.medworm.com/index.php?rid=4527735&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftop-5-most-expensive-classes-of-prescription-drugs%2F2011.02.27 The top five therapeutic classes ranked by total expense are metabolic, central nervous system, cardiovascular, gastrointestinal, and psychotherapeutic, altogether totaling $155.7 billion, or two-thirds of prescription drug expenses by U.S. adults in 2008. Two-thirds of American adults use a prescription drug, totaling the $232.6 billion in expenses. The Agency for Healthcare Research and Quality compiled a statistical brief showing that drug classes varied widely in how they made the top five list. While 46 percent of adults with a prescribed drug expense bought a central nervous system agent, they are relatively cheaper on average. Gastrointestinal agents had the highest average expense per prescription ($133), or more than three times the average expense of the cheapest class, which wa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4527735 Sun, 27 Feb 2011 15:00:00 +0100 4527735 http://www.medworm.com/index.php?rid=4525033&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcancer-survivorship-and-fear%2F2011.02.26 I had breakfast this morning in Las Vegas with my friend, Dave Garcia. Dave is a pit boss on the graveyard shift at the Belagio Hotel where they made the modern-day “Ocean’s 11″ buddy movie from 1960. Dave is also a 52-year-old chronic lymphocytic leukemia survivor. He reached out to me online and we have been friends since soon after his diagnosis in 2002. Dave is a father of two young kids. He dreams of seeing them grow up. But, understandably, he worries. Some days more than others. Today was his day to see his oncologist and get the latest blood test results. Would his white blood count (WBC) be in the normal range? If so, his third round of treatment was still working. If not, he might be headed to a stem cell transplant, short-term disability, and living in another city... Better Health blogs http://www.medworm.com/rss/comments.php?id=4525033 Sat, 26 Feb 2011 16:00:36 +0100 4525033 http://www.medworm.com/index.php?rid=4522107&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-map-app-for-wheelchair-users%2F2011.02.25 Getting around a city can be hard when you’re in a wheelchair because some places simply aren’t designed for wheels. Wheelmap is an iPhone app for wheelchair users which tells you about the accessibility of nearby restaurants, cafes, clubs, museums, and other locations. Locations are color-coded on a map to show how accessible they are. The current location, but also any place around the world, can be viewed. Maps are based on OpenStreetMap data, and accessibility data about locations can be modified and sent back to the servers by users from within the app. There is also a corresponding website showing the same information online. As with any other crowd-sourced initiative, success depends on the number of contributors, but we have good hopes for this one to succeed. Because ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4522107 Fri, 25 Feb 2011 16:00:31 +0100 4522107 http://www.medworm.com/index.php?rid=4517167&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftoner-serum-or-cream-which-first-on-your-face%2F2011.02.24 Step-by-step skin care? It’s complicated. You have a cabinet full of toners, creams, and serums and you don’t know what goes on when. Using products in the wrong order could mean you’re not getting the most for your money. Here’s a guide to make it easier for you: 1. Toners Toners are astringents, which means they contract tissue like pores, making your face feel tighter. They often contain alcohols and are used to remove oil from the skin as well as tightening. Therefore, you should use them first. If you have dry or sensitive skin, however, you might skip them completely because they can make dryness worse. 2. Serums Serums are liquid cosmetics. They usually have antioxidants or peptides to minimize the day’s damage done to your skin and to give you a more youthful appearance.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4517167 Thu, 24 Feb 2011 22:00:21 +0100 4517167 http://www.medworm.com/index.php?rid=4512394&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-are-sponges%2F2011.02.23 I am a doctor. Go ahead, call me what you may. Group me into a neatly, prejudged category: “All you doctors.” Just don’t label me a sponge. That’s right. Recently in the Wall Street Journal, Mr. Andy Kessler, famous author and former hedge fund manager smart enough to turn $100 million into $1 billion, grouped doctors into a sub-category of the service economy which he labeled as “sponges.” We could have done worse: His other categories included “sloppers” (DMV workers), “slimers” (financial planners), and “thieves” (cable companies). It seems that doctors — along with cosmetologists, lawyers, and real estate brokers — offend him because of the tests and licenses that we deem necessary: Sponges are those who earned t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4512394 Wed, 23 Feb 2011 16:00:37 +0100 4512394 http://www.medworm.com/index.php?rid=4512395&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcoronary-stent-thrombosis-and-your-body-clock%2F2011.02.23 Add coronary stent thrombosis to the list of cardiac events influenced by circadian rhythms, with more events occurring during the early morning hours and in a summertime window of late July and early August. Coronary stent thrombosis joins several other adverse cardiac events that also follow a circadian pattern, such as stroke, unstable angina pectoris, acute myocardial infarction and sudden cardiac death, according to researcher published in JACC: Cardiovascular Interventions. Most studies that addressed circadian variations in cardiovascular disease were done before the advent of stents, so, researcher from Mayo Clinic-Rochester conducted a retrospective analysis of medical records and the clinic’s registry, finding 124 patients who presented with coronary stent thrombosis betwee... Better Health blogs http://www.medworm.com/rss/comments.php?id=4512395 Wed, 23 Feb 2011 14:00:00 +0100 4512395 http://www.medworm.com/index.php?rid=4507281&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-human-genome-turns-10%2F2011.02.22 The human genome has been around for a bit more than ten years, but on February 15, 2001, the first complete human genome sequence was published. This was nothing short of a revolution within medicine. Since then, great advancements have been made in our understanding of genetics and its associations with human traits and diseases. Nature is celebrating this tenth birthday with a special titled “Human Genome at Ten.” In it, multiple papers reflect on what we learned and discovered, what is still unknown, and what we can expect for the near future. Best of all, Nature has packaged the special in a free iPad app for everyone to read, which features interactive graphs, videos, and audio commentaries. Nature special: The Human Genome at Ten… iTunes link: Nature Human Genome S... Better Health blogs http://www.medworm.com/rss/comments.php?id=4507281 Tue, 22 Feb 2011 18:00:52 +0100 4507281 http://www.medworm.com/index.php?rid=4507284&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgrand-rounds-722-%25e2%2580%2593-read-this-quickly%2F2011.02.22 Especially since the events of last week, it would be absurd for DrRich to think that everybody is out to get him. Still, it seems plain that, of late, not all individuals enjoy his efforts here at the Covert Rationing Blog. Two years ago, for instance, DrRich was “invited” to testify as a witness before a federal grand jury in a matter involving one of his consulting clients. While under oath, DrRich was caused to understand that the Feds (at least certain members of the DOJ) are well aware of this blog, and of the general tenor of its content. The impression left by this experience makes DrRich doubt whether many of his fans come from that particular precinct. Further, the CRB has been the victim of two targeted denial-of-service attacks just in the last several months. Perha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4507284 Tue, 22 Feb 2011 11:02:58 +0100 4507284 http://www.medworm.com/index.php?rid=4501583&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftheres-still-time-for-a-flu-shot%2F2011.02.21 It’s not too late to protect yourself and your family from the flu. Influenza is about to enter its peak season in the United States. Now is the time to be vigilant in protecting against and preventing the spread of flu. Washing your hands, staying home from work or school, and covering your cough can be incredible steps. But the most effective way to prevent influenza is to get vaccinated. If you haven’t had a flu shot, get one this week. Your child can be immunized if over six months of age, and remember that many children under age nine will need a second dose (booster shot). Find out how to determine if your child needs a second dose. 1o Things To Know About Influenza 1. Influenza peaks in February and March in the United States. Look at the CDC data that reflects ongoing in... Better Health blogs http://www.medworm.com/rss/comments.php?id=4501583 Mon, 21 Feb 2011 18:00:38 +0100 4501583 http://www.medworm.com/index.php?rid=4501585&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmore-physician-temps-needed-for-doctor-shortage%2F2011.02.21 The use of temporary physicians is rising, filling in until permanent physicians can be hired amid the ongoing shortage of doctors nationwide, a locum tenens firm has found. The company estimates between 30,000 and 40,000 physicians worked on a locum tenens basis in 2010. The survey, by Staff Care, polled hospital and medical group managers about their use of locum tenens. Eighty-five percent said their facilities had used temporary physicians sometime in 2010, up from 72 percent in 2009. Psychiatrists and other behavioral health specialists were the most sought-after specialty (22 percent of all requests), followed by primary care physicians, defined as family physicians, general internists and pediatricians (20 percent) and internal medicine subspecialists (12 percent). Hospitalists... Better Health blogs http://www.medworm.com/rss/comments.php?id=4501585 Mon, 21 Feb 2011 14:00:00 +0100 4501585 http://www.medworm.com/index.php?rid=4495206&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fapp-tracking-the-flu%2F2011.02.18 As a part of the TheraFlu campaign, Novartis has developed free Android, Blackberry and iPhone applications for tracking flu outbreaks in the U.S. These days it’s become inevitable to develop free apps on all platforms in order to promote your product. From Novartis: Keep up-to-date on the most active cold and flu reports around the country. The WheresFlu™ app follows sickness incidence levels from week to week and keeps track of the current top 5 affected cities in the nation. The WheresFlu™ app will find your current location and provide you with results for that area. Or you can enter a ZIP code to get information for that area. If you’re wondering how it actually works and how it differs from Google Flu Trends, here it is: WheresFlu™ measures weekly activity for cold ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4495206 Fri, 18 Feb 2011 14:00:39 +0100 4495206 http://www.medworm.com/index.php?rid=4489675&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Foutpatient-cardiology-services-and-an-out-for-hospitals%2F2011.02.16 It’s no surprise that hospitals are acquiring cardiology and primary care groups groups in droves lately. It seems there’s a signficant financial incentive to do so for now, but doctors (and especially cardiologists) should read the tea leaves ahead. From Becker’s Hospital Review: While hospitals are limited to paying fair market value for practices, they can gain an edge over competing hospitals by offering longer employment contract terms or better electronic medical record systems and management services. If hospitals move forward with a transaction, Ms. Kaplan suggests they limit employment contracts to no more than two years if possible and rebase compensation annually based on productivity. “In healthcare you shouldn’t assume anything is permanent,&#8221... Better Health blogs http://www.medworm.com/rss/comments.php?id=4489675 Wed, 16 Feb 2011 23:00:00 +0100 4489675 http://www.medworm.com/index.php?rid=4489678&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-aspects-of-the-king%25e2%2580%2599s-speech%2F2011.02.16 Over the weekend I went to see “The King’s Speech.” So far the film, featuring Colin Firth as a soon-to-be-king-of-England with a speech impediment, and Geoffrey Rush as his ill-credentialed but trusted speech therapist, has earned top critics’ awards and 12 Oscar nominations. This is a movie that’s hard not to like for one reason or another, at least most of the way through. It uplifts, it draws on history, it depends on solid acting. What I liked best, though, is the work’s rare depiction of a complex relationship between two imperfect, brave, and dedicated men. At some level, this is a movie about guys who communicate without fixating on cars, football (either kind), or women’s physical features. Great! (Dear Hollywood moguls: Can we have more like this, please?) T... Better Health blogs http://www.medworm.com/rss/comments.php?id=4489678 Wed, 16 Feb 2011 17:00:11 +0100 4489678 http://www.medworm.com/index.php?rid=4482756&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-womens-tears-do-to-men%2F2011.02.16 Humans are the only living things that cry when they are overcome with emotion. Why do we do this? A study by Noam Sobel and colleagues at the Weizmann Institute provide part of the answer, at least as it relates to women. The scientists showed that when men get a whiff of women’s tears, they experience a temporary, generalized loss of libido and a dip in testosterone. Really. (And you thought that red, runny nose was the turn off, didn’t you?) Scientists have known for decades that the chemical composition of “emotional tears” differs from tears shed due to simple irritation. But now, it appears that some of the chemicals contained in the former are actually pheromones; biological substances that create behavioral changes in others who are exposed to them. Such chemicals were kno... Better Health blogs http://www.medworm.com/rss/comments.php?id=4482756 Wed, 16 Feb 2011 15:00:32 +0100 4482756 http://www.medworm.com/index.php?rid=4482758&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-giant-artificial-gut%2F2011.02.15 What do you do when you’re one of the world’s biggest food companies and you’re looking to explore what happens after your products get chewed and swallowed? Apparently you build a large refrigerator-sized, million dollar model of a human gut, complete with valves, injection ports for enzymes, and a transparent window for visibility, of course. Nestle, in their quest to create foods that trick your body into feeling even more satisfied after eating than you otherwise would be, has a research and development center that holds this artificial gut, tucked next to the mountains in Lausanne, Switzerland. Here they’re busy studying and trying to commercialize gastrointestinal phenomenon such as the “ileal break,” a peptidal feedback mechanism that both slows transit through the GI s... Better Health blogs http://www.medworm.com/rss/comments.php?id=4482758 Tue, 15 Feb 2011 20:00:52 +0100 4482758 http://www.medworm.com/index.php?rid=4482759&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-cost-of-treating-kidney-disease%2F2011.02.15 Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits. On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent. Similar amounts were spent on prescri... Better Health blogs http://www.medworm.com/rss/comments.php?id=4482759 Tue, 15 Feb 2011 18:00:00 +0100 4482759 http://www.medworm.com/index.php?rid=4477760&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fin-the-er-with-abdominal-pain-lower-your-diagnosis-expectations%2F2011.02.15 Abdominal pain is the bane of many emergency physicians. Recently, I wrote how CT scans are on the rise in the ER. Much of those scans look for potential causes of abdominal pain. In an essay from Time, Dr. Zachary Meisel discusses why abdominal pain, in his words, is the doctor’s “booby prize.” And when you consider that there are 7 million visits annually by people who report abdominal pain, that’s a lot of proverbial prizes. One reason is the myriad of causes that lead bring a patient to the hospital clutching his abdomen. It can range from something as relatively benign as viral gastroenteritis where a patient be safely discharged home, to any number of “acute” abdominal problems necessitating surgery. But more importantly, we need to consider how limited doctors actually a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477760 Tue, 15 Feb 2011 16:00:19 +0100 4477760 http://www.medworm.com/index.php?rid=4477762&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffugus-an-unwanted-yoga-partner%2F2011.02.14 Yoga is good for your mind and body, including your skin. Yoga mats, on the other hand, might not be. Using someone else’s yoga mat for an hour could lead to an infection. Fungal infections are common and appear as athlete’s foot, toenail fungus, and ringworm. Unfortunately, the fungus can survive on surfaces like mats long after the infected person has left. Although most people blame the gym locker room when they develop athlete’s foot, you can catch the fungus from a variety of places anytime you walk barefoot. Fortunately, even if the fungus comes into contact with your skin, it doesn’t always lead to infection. Dry, cracked skin, or soft, wet skin disrupt your primary defense against the fungus — the densely packed barrier of skin cells, oils and proteins on your healthy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477762 Mon, 14 Feb 2011 23:00:35 +0100 4477762 http://www.medworm.com/index.php?rid=4477763&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-physical-and-metaphorical-heart%2F2011.02.14 Listening to NPR on Saturday morning I caught part of Scott Simon’s interview with brothers Stephen Amidon and Thomas Amidon, M.D. discussing their book “The Sublime Engine: A Biography of the Human Heart.” The interview touched on the story of the human heart in science and medicine, history, and culture:  It turns out that the classic red heart symbol we see almost everywhere around Valentine’s Day doesn’t look much like a real human heart at all. “Of all the theories about where that symbol comes from, my favorite is that it is a representation of a sixth century B.C. aphrodisiac from northern Africa,” says Stephen Amidon…”And I kind of like that history because it sort of suggests that early on, people sort of understood the conne... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477763 Mon, 14 Feb 2011 19:00:00 +0100 4477763 http://www.medworm.com/index.php?rid=4472948&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-your-health-hinders-your-love-life%2F2011.02.13 This is the time of year when stores are filled with red hearts and other reminders that Valentine’s Day is approaching. It’s a mood booster, not to mention a nice break from all that winter grey (at least up here in Boston). After all, what would life be like without romance, love — and sex? Unfortunately, a variety of health problems — as well as some of the treatments for them — can get in the way of sexual desire and functioning. Here’s a quick look at some of the main sources of trouble and suggestions about what to try first. If these initial strategies don’t work, have a heart to heart with your doctor about what to do next. There may not be a quick fix for health-related sexual problems, but there are steps you can take to help ensure that you can still en... Better Health blogs http://www.medworm.com/rss/comments.php?id=4472948 Sun, 13 Feb 2011 21:00:26 +0100 4472948 http://www.medworm.com/index.php?rid=4472949&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-nursing-shortage-a-big-disconnect%2F2011.02.13 With the aging of America, it’s well known that there will be a shortage of registered nurses and nursing assistants to take care of the population. It’s predicted that the shortage of nurses in California will climb to 80,000 by 2015. California has just 653 registered nurses employed per 100,000 people. One of the problems is a lack of qualified faculty to teach at nursing schools. California was forced to turn away 23,000 qualified applicants from nursing programs during 2008-2009. And this week Humboldt State University announced plans to discontinue the school’s nursing program because of financial concerns and inability to retain nursing faculty. Shortage of nurses and closing nursing programs — now there’s a big disconnect. *This blog post was ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4472949 Sun, 13 Feb 2011 19:00:00 +0100 4472949 http://www.medworm.com/index.php?rid=4470412&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgender-differences-in-exercise%2F2011.02.12 Obesity levels are at an all-time high among men, women, and children in the United States. The need for good nutrition and regular exercise is paramount for maintaining proper health and for keeping those extra pounds at bay, especially for women. Beginning in her late 20s and 30s, a woman’s average body weight climbs steadily each year. This increase usually continues into her 60s. For many women, the weight gain is between one to two pounds per year with some women gaining more, and others less. Aside from weight loss, women who incorporate regular exercise into their daily schedules may lower the risks of certain diseases and conditions. A recent study presented at the Ninth Annual AACR Frontiers in Cancer Prevention Research Conference revealed that women who exercised for at least ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4470412 Sat, 12 Feb 2011 14:00:00 +0100 4470412 http://www.medworm.com/index.php?rid=4464494&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiologists-as-heart-whisperers%2F2011.02.11 From the Dallas Morning News, a creative moniker if there ever was one, but it should probably be reserved for primary care specialists instead: DALLAS — Heart attacks are the No. 1 cause of death and a major cause of disability in America. For nearly half of the casualties, the first symptom is the last. That’s how cardiovascular disease has earned the nickname “silent killer” — you never know when it will strike. Doctors are trying to change that by treating heart disease as a progressive problem. They are becoming “heart whisperers,” seeking new tests to read the small stresses that can, unchecked, grow into big ones. “By the time someone rolls in with a heart attack, his family will look at me bewildered, and the patient may say, ‘Doc, wha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4464494 Fri, 11 Feb 2011 20:00:00 +0100 4464494 http://www.medworm.com/index.php?rid=4459958&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmind-over-matter-in-medicine%2F2011.02.10 [Recently] I came upon a Jan 24 op-ed, “A Fighting Spirit Won’t Change Your Life” by Richard Sloan, Ph.D., of Columbia University’s psychiatry department. Somehow I’d missed this worthwhile piece on the sometimes-trendy notion of mind-over-matter in healing and medicine. Sloan opens with aftermath of the Tucson shootings: …Representative Giffords’s husband describes her as a “fighter,” and no doubt she is one. Whether her recovery has anything to do with a fighting spirit, however, is another matter entirely. He jumps quickly through a history of the mind cure movement in America: From Phineas Quimby’s concept of illness as a product of mistaken beliefs — to William James and “New Thought” ideas — to Norman Vincent Peale’s 1952 “... Better Health blogs http://www.medworm.com/rss/comments.php?id=4459958 Thu, 10 Feb 2011 22:00:02 +0100 4459958 http://www.medworm.com/index.php?rid=4459960&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-medical-clowning-improve-in-vitro-success%2F2011.02.10 Following from the somewhat common sense idea that women who were less stressed during in vitro fertilization and embryo transfer (IVF-ET) had better outcomes, the journal Fertility and Sterility published a study out of Israel that claims “medical clowning” improved pregnancy rates compared to a group not exposed to a clown on the day of implantation. From the abstract: This experimental prospective quasi-randomized study examining the impact of a medical clowning encounter after ET after IVF found that the pregnancy rate in the intervention group was 36.4%, compared with 20.2% in the control group (adjusted odds ratio, 2.67; 95% confidence interval, 1.36–5.24). Medical clowning as an adjunct to IVF-ET may have a beneficial effect on pregnancy rates and deserves further inve... Better Health blogs http://www.medworm.com/rss/comments.php?id=4459960 Thu, 10 Feb 2011 16:00:47 +0100 4459960 http://www.medworm.com/index.php?rid=4455266&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctor-who-attempted-to-have-whistleblowing-nurses-prosecuted-is-put-on-probation%2F2011.02.09 From an AP article in the Dallas-Fort Worth Star-Telegram: AUSTIN — Texas medical regulators on Friday placed on probation a West Texas doctor involved in the unsuccessful prosecution of two nurses who complained anonymously that the physician was unethical and risking patients’ health. The Texas Medical Board technically suspended Dr. Rolando G. Arafiles Jr. but allowed him to continue to practice medicine while on probation for four years if he completes additional training. The board also said Arafiles must be monitored by another physician and submit patient medical and billing records for review. The monitor will report his or her findings to the board. In the mediated order signed in Austin, the board concluded that Arafiles failed to treat emergency room patients properly, did... Better Health blogs http://www.medworm.com/rss/comments.php?id=4455266 Wed, 09 Feb 2011 14:00:20 +0100 4455266 http://www.medworm.com/index.php?rid=4450291&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fear-infections-to-treat-or-not-to-treat%2F2011.02.08 Ear infections used to be a devastating problem. In 1932, acute otitis media (AOM) and its suppurative complications accounted for 27 percent of all pediatric admissions to Bellevue Hospital. Since the introduction of antibiotics, it has become a much less serious problem. For decades it was taken for granted that all children with AOM should be given antibiotics, not only to treat the disease itself but to prevent complications like mastoiditis and meningitis. In the 1980s, that consensus began to change. We realized that as many as 80 percent of uncomplicated ear infections resolve without treatment in three days. Many infections are caused by viruses that don’t respond to antibiotics. Overuse of antibiotics leads to the emergence of resistant strains of bacteria. Antibiotics cause ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450291 Tue, 08 Feb 2011 22:00:44 +0100 4450291 http://www.medworm.com/index.php?rid=4450292&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-when-medicine-prolongs-dying-not-living%2F2011.02.08 The recent Washington Post article entitled, Who decides when medicine prolongs dying, not living? perfectly captures my earlier blog on why we’re afraid of death. An excerpt from the Post piece: [There's a] huge gap between Americans’ wishes about end-of-life care, as expressed in numerous public opinion polls, and what actually happens in too many instances–futile, expensive, often painful procedures performed on people too sick to leave the hospital alive–much less survive with a decent quality of life. Ninety percent of Americans say they want to die at home but only 20 percent do so. Half of Americans die in hospitals and another 25 percent in nursing homes, after a long period of suffering from chronic, incurable conditions that finally become untreatable. An ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450292 Tue, 08 Feb 2011 20:00:00 +0100 4450292 http://www.medworm.com/index.php?rid=4450294&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdifficult-patients%2F2011.02.08 Physicians see nearly one in five patients as “difficult,” report researchers. Not surprisingly, these patients don’t fare as well as others after visiting their doctor. Researchers took into account both patient and clinician factors associated with being considered “difficult,” as well as assessing the impact on patient health outcomes. They reported results in the Journal of General Internal Medicine. Researchers assessed 750 adults prior to their visit to a primary care walk-in clinic for symptoms, expectations, and general health; for how they functioned physically, socially and emotionally; and whether they had mental disorders. Immediately after their visit, participants were asked about their satisfaction with the encounter, any unmet expectations, and... Better Health blogs http://www.medworm.com/rss/comments.php?id=4450294 Tue, 08 Feb 2011 16:00:00 +0100 4450294 http://www.medworm.com/index.php?rid=4445802&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-your-avatar-affect-the-way-you-live%2F2011.02.07 If you own a Nintendo Wii, have played World of Warcraft, or seen James Cameron’s cinematic spectacle, then you probably know what an avatar is. And because an avatar is simply a representation of yourself that you design, your avatar’s attributes could be as similar or different to you as you wish. [This editor's avatar is 6' 8", has six-pack abs, wears only fine European clothing, and has the voice of YouTube sensation Ted Williams.] Do online avatars have any influence on their real-world counterparts? Researchers at the new Virtual Human Interaction Lab (VHIL) at Stanford University think so. According to VHIL, while avatars tend to be idealized versions of their users, evidence has suggested one’s virtual avatar does indeed influence a person. In one experiment, a fe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4445802 Mon, 07 Feb 2011 20:00:16 +0100 4445802 http://www.medworm.com/index.php?rid=4445804&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-problem-with-casual-medical-advice%2F2011.02.07 It’s happening more frequently: Requests for medical advice by email. The more I do, the more people I meet. The network grows and friends of friends learn about what I do. So junior has a little pain and shows at the local ER where the requisite CT shows a little thickening of the ileum. Someone suggests that the family drop me a line. Here’s the problem: There’s more to this than digital correspondence will allow. While the statistical reality of this child’s situation is that this finding represents a little edema from a virus, the differential is precarious: Crohn’s disease, lymphoma, tuberculous ileitis, eosinophilic enteropathy. A case of this type requires the thorough exploration of a child’s story and a compulsive exam that takes into consideration the problems in the... Better Health blogs http://www.medworm.com/rss/comments.php?id=4445804 Mon, 07 Feb 2011 14:00:30 +0100 4445804 http://www.medworm.com/index.php?rid=4441972&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fis-february-heart-marketing-month%2F2011.02.06 Heart disease and February: What relationship could be more cozy? From the scary risks of shoveling snow (yep, you could die, so be sure to lift a little at a time), Mercedes-sponsored red dress parades and government-sponsored National Wear Red Day®, to tips for identifying heart attacks in women (men, you need a different month I guess), February has all the important stories to improve your awareness. Such a polite term “awareness.” But I wonder, now that the Internet is upon us and people are seeing their insurance rates and co-pays skyrocket, if maybe we’re shooting ourselves in the foot with all this heart-month marketing hype. People are sick and tired of testing “just to be sure.” It’s starting to directly cost them a fortune, and people are fr... Better Health blogs http://www.medworm.com/rss/comments.php?id=4441972 Sun, 06 Feb 2011 22:00:00 +0100 4441972 http://www.medworm.com/index.php?rid=4441974&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fputting-your-heart-into-the-super-bowl%2F2011.02.06 Sports fans may literally live and die on their team’s victories, according to researchers who examined cardiac mortality rates after the home team won and lost the Super Bowl. Total and cardiac mortality rates in Los Angeles County increased after the football team’s 1980 Super Bowl loss but overall mortality fell after the 1984 the team’s Super Bowl win, researchers concluded from a review of death certificates reported in Clinical Cardiology. First, authors gave a clinical review. Stress causes a cardiac cascade. The sympathetic nervous system increases and releases catecholamines. This triggers a rise in heart rate and blood pressure, and ventricular contractility increases oxygen demand, causing blood the sheer against and fracture atherosclerotic plaque, the authors... Better Health blogs http://www.medworm.com/rss/comments.php?id=4441974 Sun, 06 Feb 2011 16:00:00 +0100 4441974 http://www.medworm.com/index.php?rid=4436749&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Favoid-weight-gain-by-using-brain-tricks-to-master-portion-control%2F2011.02.04 When I was growing up, my parents had a simple rule when it came to food: “Finish everything on your plate.” We had to sit at the table until we did. They meant well. They wanted us to understand that food should not go to waste. The problem with this advice — and I’m sure I’m not the only American who grew up with it — is that we learned early on to eat everything put in front of us when we sat down to meals. Then the size of the plates grew — and so did the amount of food we consumed. It’s called portion inflation. Take a look at the illustration at left. It’s based on an analysis published in the Journal of the American Dietetic Association which found that typical restaurant portion sizes today are two to eight times as large as those in 1955. Back then, p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4436749 Fri, 04 Feb 2011 18:00:41 +0100 4436749 http://www.medworm.com/index.php?rid=4436750&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftoo-drunk-to-drive-your-car-will-tell-you-if-s%2F2011.02.04 Drunk driving continues to be a serious problem. In 2009 for example, alcohol was a factor in more than 10,000 highway deaths. The same year, a stunning 10 percent of respondents to a survey of U.S. adults said they had operated an automobile while drunk during the previous year. Nearly 6 percent said they had done it more than once. So how would you feel about a car that can instantly detect whether a driver is drunk and prevent that person from starting the car? You better make up your mind quickly, because scientists are close to perfecting this technology. “We’re five to seven years away from being able to integrate this into cars,” Robert Strassburger, the VP for safety at the Alliance of Automobile Manufacturers (AAM) told the Washington Post. The AAM, an automotive trade... Better Health blogs http://www.medworm.com/rss/comments.php?id=4436750 Fri, 04 Feb 2011 16:00:23 +0100 4436750 http://www.medworm.com/index.php?rid=4433101&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fconfronting-the-empty-cradles-of-infant-mortality%2F2011.02.03 I have gushed praise for the Milwaukee Journal Sentinel for a long time. (Disclosure: I cut my teeth in journalism as a Journal Company employee way back in 1973. No ties since 1976.) As a mid-market newspaper facing all of the same hurdles as other newspapers, it consistently demonstrates tenacity and creativity in tackling vital healthcare issues in this country. The latest: A project called “Empty Cradles: Confronting Our Infant Mortality Crisis.” While there is a great health/medicine/science team in place at the Journal Sentinel, I believe that much of the credit goes to the top — to editor Marty Kaiser, who clearly understands that healthcare issues are among the most important his paper can report on in serving public needs. Kaiser writes: “The Journal Sen... Better Health blogs http://www.medworm.com/rss/comments.php?id=4433101 Thu, 03 Feb 2011 23:00:29 +0100 4433101 http://www.medworm.com/index.php?rid=4429020&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-physician-exodus-when-doctors-leave-hospitals-behind%2F2011.02.02 My partners and I have long struggled with the lack of specialty back-up at our hospital. Semi-rural hospitals, out of the way facilities, just can’t always attract specialists. So, we’re happy to have cardiologists every night, but understand that we only have an ENT every third night. We’re thankful to have neurologists, even if they don’t admit anyone. We’re glad to have radiologists, even if they don’t read plain films after 5PM on weekdays. Still, I continue to scratch my head about why only three of seven community pediatricians take call, such that family physicians have to admit their patients. I was bumfuzzled that our neurologists were previously going to require us to use telemedicine for stroke evaluation when their offices were close by the hospital. (In the same y... Better Health blogs http://www.medworm.com/rss/comments.php?id=4429020 Wed, 02 Feb 2011 17:00:12 +0100 4429020 http://www.medworm.com/index.php?rid=4424233&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fe-patient-goes-mainstream%2F2011.02.01 I have a Google alert for “e-patient,” and sometimes I’m surprised what it catches. [Recently] it was this: 3 Reasons Steve Jobs Will Be The Ultimate e-Patient Steve Jobs’ medical leave sets the stage for the upcoming revolution in the production and delivery of medical information at time of diagnosis. 3 things you need to know. So I’m thinking: “Oh, wow: Is the term ‘e-patient’ going mainstream?” That would be a hoot, because indeed the Society for Participatory Medicine is engaged in spreading the word. *This blog post was originally published at e-Patients.net* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4424233 Tue, 01 Feb 2011 22:00:04 +0100 4424233 http://www.medworm.com/index.php?rid=4424236&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-eroding-doctor-label%2F2011.02.01 It came as a Twitter “follow” from @coldfeet65, a self-proclaimed “Nurse Practitioner Hospitalist.” I had never heard this term before. Does it mean a nurse practitioner who cares for hospitalists? Or is it a hospitalist who is a nurse practitioner? Or maybe it’s a nurse practitioner who helps hospitalists? (Honestly, I think I know which one she means, but you get my point.) Perhaps this is a prescient glimpse to healthcare of the future, where our more typical nurse and doctor labels are supplanted by more and more monikers that serve to confuse, rather than clarify, each of our roles in healthcare delivery. As specialists in cardiology, we’ve seen a similar trend with cardiology hospitalists. But we should be clear what this means to the patients and ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4424236 Tue, 01 Feb 2011 16:00:00 +0100 4424236 http://www.medworm.com/index.php?rid=4424237&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffire-department-app-theres-a-hero-in-all-of-us%2F2011.02.01 Just admit it: Deep in your heart you’ve always wanted to be an emergency medical technician, if at least for a few moments. If you’re located in San Ramon Valley, California, you can now live that dream: The local fire department has released an iPhone app that will alert you of any emergency activity in the area. The well thought-out application will send out a push notification to users who have indicated that they are proficient in CPR whenever there is a cardiac emergency nearby. In addition, the closest public-access automated external defibrillator (AED) is located by the app. Current response status of dispatched units are shown and incident locations are pinpointed on an interactive map. There’s even a log of recent incidents including a photo gallery. For the ol... Better Health blogs http://www.medworm.com/rss/comments.php?id=4424237 Tue, 01 Feb 2011 14:00:12 +0100 4424237 http://www.medworm.com/index.php?rid=4414523&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-a-surgeons-note-has-to-begin-with-i-certify%2F2011.01.28 You know it’s bad when the attending surgeon has to write this at the beginning of his operative note: “I certify that the services for which payment is claimed were medically necessary and that no qualified resident was available to perform the services.” So there you have it. -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4414523 Fri, 28 Jan 2011 20:00:00 +0100 4414523 http://www.medworm.com/index.php?rid=4411526&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-a-surgeons-note-has-to-begin-with-i-certify%2F2011.01.28 You know it’s bad when the attending surgeon has to write this at the beginning of his operative note: “I certify that the services for which payment is claimed were medically necessary and that no qualified resident was available to perform the services.” So there you have it. -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4411526 Fri, 28 Jan 2011 20:00:00 +0100 4411526 http://www.medworm.com/index.php?rid=4405773&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffeeling-s-a-d-lighten-up-if-it%25e2%2580%2599s-seasonal-affective-disorder%2F2011.01.27 This picture shows the view from my office window in Boston: Dull, dreary, and depressing — at least on overcast days like today. Lack of light is one of the reasons that people feel mentally foggy. One of the bloggers I follow, Rachel Zimmerman of WBUR’s CommonHealth blog, recently wrote that she’s been drinking three times as much coffee as usual. In addition to imbibing more caffeine, I’ve been trying to boost my spirits and alertness with mid-day runs to the snack machine (not the best strategy, in case you’re wondering). At this time of year, many people aren’t just foggy and sad — they’ve got SAD, or seasonal affective disorder. About half a million Americans — women more often than men — are diagnosed with seasonal affective disorder each year. Ma... Better Health blogs http://www.medworm.com/rss/comments.php?id=4405773 Thu, 27 Jan 2011 22:00:27 +0100 4405773 http://www.medworm.com/index.php?rid=4405779&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhope-for-those-with-body-dysmorphic-disorder%2F2011.01.26 The Science Daily article entitled Body dysmorphic disorder patients who loathe appearance often get better, but it could take years discusses the disorder as highlighted in the Journal of Nervous and Mental Disease (JNMD).   The JNMD article reports the results of the longest-term study so far to track people with body dysmorphic disorder (BDD). The study was conducted by researchers at Brown University and Rhode Island Hospital. The good news? The researchers “found high rates of recovery, although recovery can take more than five years.” This is a small study with only 15 BDD patients who were followed over an eight-year span. An excerpt: After statistical adjustments, the recovery rate for sufferers in the study over eight years was 76 percent and the recurrence rate was 14 p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4405779 Wed, 26 Jan 2011 20:00:00 +0100 4405779 http://www.medworm.com/index.php?rid=4399525&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-older-doctors-continue-to-treat-patients%2F2011.01.25 Did you know that one-third of the country’s physicians are over the age of 65? That’s right, there’s a good chance that your doctor is on Medicare. That’s a concern, because physicians aren’t immune to the ails of aging, and are just as prone as patients to succumb to the effects of Parkinson’s or various types of dementias. Not comforting if you’re about to undergo an operation, for instance. And absolutely frightening when you consider baby boomers and newly-insured patients will flood our health system in the coming years. An eye-opening piece from the New York Times highlights the trend. It’s up to doctors and medical societies to report doctors who aren’t able to proficiently perform, but few do. According to the data, the rate of disciplinary action for physician... Better Health blogs http://www.medworm.com/rss/comments.php?id=4399525 Tue, 25 Jan 2011 22:00:06 +0100 4399525 http://www.medworm.com/index.php?rid=4399526&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Factual-living-breathing-lungs-on-stage-at-tedmed-2010%2F2011.01.25 Dr. Shaf Keshavjee, a thoracic surgeon and director of the Toronto Lung Transplant Program, showed the amazing miracle of modern lung transplantation at TEDMED 2010. Here’s his fascinating talk where an actual living, breathing set of porcine lungs were brought on stage for hands-on inspection by the audience: Here’s a quick interview we were able to get with Dr. Keshavjee just after the talk: (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4399526 Tue, 25 Jan 2011 20:00:06 +0100 4399526 http://www.medworm.com/index.php?rid=4399528&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-planning-makes-it-easier-to-say-goodbye%2F2011.01.25 This is a guest post by Dr. Barbara Okun and Dr. Joseph Nowinski. *********** End-Of-Life Planning Makes It Easier To Say Goodbye Saying goodbye as the end of life approaches can be difficult, even for those with a gift for words. In a moving account in a recent issue of The New Yorker, writer Joyce Carol Oates describes the last week of her 49-year marriage, as her husband was dying from complications of pneumonia. Like A Year of Magical Thinking, Joan Didion’s poignant memoir of her husband’s sudden death and its aftermath, Oates’ essay highlights the need for each of us to think about death and dying — and discuss them with loved ones — long before they become a likelihood. In our work with individuals and families facing death, we have seen too many people miss the op... Better Health blogs http://www.medworm.com/rss/comments.php?id=4399528 Tue, 25 Jan 2011 16:00:02 +0100 4399528 http://www.medworm.com/index.php?rid=4394444&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-the-end-of-internal-medicine-as-we-know-it-might-be-a-good-thing%2F2011.01.24 A recent post on the Health Affairs blog proclaimed “The End of Internal Medicine As We Know It.” What the post is really asking about is the future of primary care in the world of healthcare reform and the creation of accountable care organizations (ACOs). While doctors should be naturally concerned about change, I don’t completely agree with this article. ACOs are organizations that are integrated and accountable for the health and well-being of a patient and also have joint responsibilities on how to thoughtfully use a patient’s or employer’s health insurance premium, something that is sorely lacking in the current health care structure. These were recently created and defined in the healthcare reform bill. Yet the author seems to suggest that this is a s... Better Health blogs http://www.medworm.com/rss/comments.php?id=4394444 Mon, 24 Jan 2011 20:00:00 +0100 4394444 http://www.medworm.com/index.php?rid=4394445&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-is-a-%25e2%2580%259ccomplete%25e2%2580%259d-physical%2F2011.01.24 A reader requests: Can you do a post on what procedures constitute a thorough physical, in your opinion? I haven’t had one in several years and thinking of making an appointment now. The last doctor I went to didn’t even listen to my heart or go though the motions with feeling my belly and that stuff. And of the last three doctors I went to, I realized they didn’t bring up my immunization records. Is this usually left for the patients to bring up on their own? Good question. What exactly is a physical? Does it include blood work? What about an EKG? And a cardiac stress test? Is an “executive physical” an orgy of “more is better,” previously paid lavishly, really better than a “camp physical?” Here’s the thing: There is no such thing as a “complete physical exami... Better Health blogs http://www.medworm.com/rss/comments.php?id=4394445 Mon, 24 Jan 2011 18:00:47 +0100 4394445 http://www.medworm.com/index.php?rid=4394446&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-ethics-why-they-should-matter-to-patients%2F2011.01.24 Medical ethics has properly gained a foothold in the public square. There is a national conversation about euthanasia, stem cell research, fertilization and embryo implantation techniques, end-of-life care, prenatal diagnosis of serious diseases, defining death to facilitate organ donation, cloning and financial conflicts of interest. Nearly every day, we read (or click) on a headline highlighting one of these or similar ethical controversies. These great issues hover over us. We physicians face ethical dilemmas every day in the mundane world of our medical practices. They won’t appear in your newspapers or pop up on your smartphones, but they are real and they are important. Here is a sampling from the everyday ethical smorgasbord that your doctor faces. How would you act under the fol... Better Health blogs http://www.medworm.com/rss/comments.php?id=4394446 Mon, 24 Jan 2011 16:00:00 +0100 4394446 http://www.medworm.com/index.php?rid=4389184&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcombating-concussions-impact-sensors-for-nfl-players-helmets%2F2011.01.23 Anyone who’s ever watched football, the American variety, knows how rough of a sport it can be. With 22 fast-moving players (some weighing as much as 350 pounds) scrambling and tackling for possession of the pigskin, injuries are inevitable. One of the scariest injuries a football player can get is a concussion. With its commonly insidious onset, concussions of the brain are often difficult to diagnose, or immediately treat to avoid long-term consequences. The National Football League (NFL) has announced that they will be launching a pilot program next season in which accelerometers will be placed in players’ mouthpieces, earpieces, and helmets to analyze how blows to the head relate to the effects and severity of concussions and other traumatic brain injuries. The data could p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4389184 Sun, 23 Jan 2011 14:00:33 +0100 4389184 http://www.medworm.com/index.php?rid=4382764&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-homicide-safer-to-work-in-a-prison-than-in-a-hospital%2F2011.01.21 There’s been a lot of stories in the news lately about homicides committed in hospitals. Just out of curiosity, I went to the Bureau of Labor Statistics (BLS) website and pulled some data from their Census of Fatal Occupational Injuries. It confirmed what I suspected — that homicides of workers in hospitals have increased at twice the rate as correctional facilities, where worker homicides have remained stable. Here’s the graph I was able to make from the BLS data: The red bars (hospital murders) are up to six and seven homicides per year while the blue bars (correctional facility murders) have remained stable at about three per year. This is only for the employees who have been murdered, not all murder victims. When we consider the cost and repercussions of increased ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4382764 Fri, 21 Jan 2011 18:00:00 +0100 4382764 http://www.medworm.com/index.php?rid=4382766&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-doctors-feel-about-patients-who-google-their-symptoms%2F2011.01.21 Many doctors roll their eyes whenever patients bring in a stack of research they printed out, stemming from a Google search of their symptoms. A piece by Dr. Zachary Meisel on TIME.com describes a familiar scenario: The medical intern started her presentation with an eye roll. “The patient in Room 3 had some blood in the toilet bowl this morning and is here with a pile of Internet printouts listing all the crazy things she thinks she might have.” The intern continued, “I think she has a hemorrhoid.” “Another case of cyberchondria,” added the nurse behind me. It’s time to stop debating whether patients should research their own symptoms. It’s happening already, and the medical profession would be better served to handle this new reality. According to the Pew Internet and ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4382766 Fri, 21 Jan 2011 14:00:37 +0100 4382766 http://www.medworm.com/index.php?rid=4377568&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhead-lice-fda-approves-new-treatment%2F2011.01.20 Good news for parents, teachers, pediatricians, and others engaged in the ongoing battle against lice: The Food and Drug Administration (FDA) just approved a new treatment for head lice in children age four and older. Called Natroba, it’s a liquid that is rubbed into the hair and allowed to sit for 10 minutes before being rinsed off. Natroba is a useful addition to the anti-lice arsenal, since some head lice have become resistant to permethrin and pyrethrins, the active ingredients in over-the-counter anti-lice products such as Nix and Rid. Head lice are tiny insects that go by the big name Pediculus humanus capitis. They thrive in the warm tangle of human hair, feeding off blood in the scalp and breeding with abandon. A female lays eggs called nits that she attaches to strands of hair.... Better Health blogs http://www.medworm.com/rss/comments.php?id=4377568 Thu, 20 Jan 2011 21:30:14 +0100 4377568 http://www.medworm.com/index.php?rid=4377571&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpersonal-genetic-testing-psychological-and-behavioral-effects%2F2011.01.20 In conclusion, personal genetic testing does not seem to generate a lot of distress, although the study was clearly limited by a high dropout percentage of 44 percent and the self-selection of participants who opted to do the test. Article in New England Journal of Medicine: Effect of Direct-to-Consumer Genomewide Profiling to Assess Disease Risk Flashback: An Interview with Navigenics… *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4377571 Thu, 20 Jan 2011 16:00:21 +0100 4377571 http://www.medworm.com/index.php?rid=4377572&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-is-secondary-prevention%2F2011.01.20 A November letter to the editor in American Family Physician chastises that publication for misusing the term “secondary prevention,” even using it in the title of an article that was actually about tertiary prevention. I am guilty of the same sin. I had been influenced by simplistic explanations that distinguished only two kinds of prevention: Primary and secondary. I thought primary prevention was for those who didn’t yet have a disease, and secondary prevention was for those who already had the disease, to prevent recurrence or exacerbation. For example, vaccinations would be primary prevention and treatment of risk factors to prevent a second myocardial infarct would be secondary prevention. No, there are three kinds of prevention: Primary, secondary and tertiary. Primary prevent... Better Health blogs http://www.medworm.com/rss/comments.php?id=4377572 Thu, 20 Jan 2011 14:00:52 +0100 4377572 http://www.medworm.com/index.php?rid=4372044&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-good-is-your-doctor-at-diagnosing-you%2F2011.01.19 We’ve all been there. It often starts with some kind of recurring pain or dull ache. We don’t know what’s causing the pain or ache. During the light of day we tell ourselves that it’s nothing. But at 3:00am when the pain wakes you, worry sets in: “Maybe I have cancer or heart disease or some other life-ending ailment.” The next day you make an appointment to see your doctor. So now you’re sitting in the exam room explaining this scenario to your doctor. Based on your previous experience, what’s the first thing your doctor would do? A. Order a battery of tests and schedule a follow-up appointment. B. Put you in a patient gown and conduct a thorough physical examination, including asking you detailed questions about your complaint before ordering any test... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372044 Wed, 19 Jan 2011 22:00:07 +0100 4372044 http://www.medworm.com/index.php?rid=4372046&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsimple-blood-test-for-cancer-breakthrough-or-nightmare%2F2011.01.19 That’s the question Dartmouth’s Dr. Gil Welch asks in a column on the CNN website. He reflects on [recent] news about a test in development that might find a single cancer cell among a billion healthy ones — as so many news stories framed it. Welch analyzes: “But it’s not that simple. The test could just as easily start a cancer epidemic. … Most assume there are no downsides to looking for things to be wrong. But the truth is that early diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden side-effect: overdiagnosis, the detection of abnormalities that are not destined to ever bother people in their lifetime. Becoming a patient unnecessarily has real human costs. There’s the anxiety of being told you ar... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372046 Wed, 19 Jan 2011 18:00:29 +0100 4372046 http://www.medworm.com/index.php?rid=4372047&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-doctors-be-allowed-to-self-refer%2F2011.01.19 Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue — a practice called “self-referral” — unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, X-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less inconvenience and speeder diagnosis and treatment — what could be wrong with that? Much, say the critics, if it leads to overutilization and higher costs and doesn’t really represent a convenience to patients. This is the gist of two studies by staff employed by the American College of Radiology, published in the December issue of Health Affa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372047 Wed, 19 Jan 2011 16:00:00 +0100 4372047 http://www.medworm.com/index.php?rid=4372048&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsynthetic-blood-via-artificial-cells-and-platelets-from-stem-cells%2F2011.01.19 There’s hema­tology news, times two (at least): 1. Progress in devel­oping syn­thetic red blood cells A University of North Carolina-Chapel Hill research group has created hydrogel par­ticles that mimic the size, shape and flex­i­bility of red blood cells (RBCs). The researchers used PRINT® (Particle Replication in Non-wetting Templates) tech­nology to gen­erate the fake RBCs, which are said to have a rel­a­tively long half-life. The findings were reported on-line yes­terday in the Proceedings of the National Academy of Sciences (PNAS) (abstract available, sub­scription required for full text). According to a PR-ish but inter­esting post on Futurity, a website put forth by a con­sortium of major research uni­ver­sities, tests of the par­ticles’ ability to ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372048 Wed, 19 Jan 2011 14:00:47 +0100 4372048 http://www.medworm.com/index.php?rid=4360977&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpoint-and-click-medicine-the-emr-game%2F2011.01.18 Whistleblower readers know of my criticisms of the electronic medical record (EMR) juggernaut that is oozing over the medical landscape. Ultimately, this technology will make medical care better and easier to practice. All systems will be integrated, so that a physician will have instant access to his patients’ medical data from other physicians’ offices, emergency rooms and hospitals. In addition, data input in the physician’s office will use reliable voice activated technology, so that some antiquated physician behaviors, such as eye contact, can still occur. Clearly, EMR is in transition. I place it on the 40 yard line, a long way from a touch down or field goal position. A colleague related a distressing meeting he had at the community hospital he works at. This hospital, like ne... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360977 Tue, 18 Jan 2011 20:00:00 +0100 4360977 http://www.medworm.com/index.php?rid=4360978&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprotect-your-heart-when-shoveling-snow%2F2011.01.18 After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.  What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360978 Tue, 18 Jan 2011 18:00:40 +0100 4360978 http://www.medworm.com/index.php?rid=4360980&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffarm-woo-and-our-food%2F2011.01.18 Google is an amazing thing — it occasionally tosses you a link that lands you in an alternate universe of folks you’d never encounter in real life. Like cattle ranchers. I’ve just spent the good part of an hour wandering their world — reading about their concerns (water, wolves, the economy), seeing how cattle breeding has changed (you pick a sire at Bullsemen.com, then do genomic profiling on your stock — did you know that cows bred for docility have more tender meat ?), and learning that ranchers are not immune to marketing from the world of scientific woo. Check this out — it’s called SOP Life Vibration or “Serio Bio-Hygienization.” They’re selling it to farmers and ranchers in Europe and the U.S. as the latest and greatest answer to bacterial growth... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360980 Tue, 18 Jan 2011 14:00:17 +0100 4360980 http://www.medworm.com/index.php?rid=4360982&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fkids-with-dyslexia-predicting-their-reading-skills-with-mri%2F2011.01.17 An international team of researchers has developed a rather reliable test that predicts the future improvement of reading abilities in kids with dyslexia. The method uses functional MRI (fMRI) and diffusion tensor magnetic resonance imaging (DTI) to scan the brain, and data crunching software to interpret the data. The researchers hope that the finding will help parents and therapists uniquely identify which learning tools are best for each child. From the announcement by Vanderbilt University : The 45 children who took part in the study ranged in age from 11 to 14 years old. Each child first took a battery of tests to determine their reading abilities. Based on these tests, the researchers classified 25 children as having dyslexia, which means that they exhibited significant difficulty le... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360982 Tue, 18 Jan 2011 00:00:02 +0100 4360982 http://www.medworm.com/index.php?rid=4360983&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fchewable-birth-control%2F2011.01.17 Just in time for the new year, the FDA has approved the first low-dose chewable birth control contraceptive.  The daily chew will be marketed by Watson Pharmaceuticals, Inc. Fred Wilkinson, executive vice president of Global Brands said: “We believe this product is an important addition to the oral contraceptive category, and that its characteristics will make it a desirable choice for women.” I have to ask myself: “Why?” Most birth control failures occur because the woman forgets to take the pill. Will a chewable be more reliant? Is it aimed at gals who just love chewing gum? I don’t get the concept. Marketing for this breakthrough will begin the in the second quarter of 2011. *This blog post was originally published at EverythingHealth* (Source: ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360983 Mon, 17 Jan 2011 22:00:00 +0100 4360983 http://www.medworm.com/index.php?rid=4360984&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcancer-treatments-to-cost-158-billion-by-2020%2F2011.01.17 Medical expenditures for cancer are projected to reach at least $158 billion in today’s dollars by 2020. That’s a 27 percent increase, assuming that incidence and treatment costs remain at 2010 levels, according to a National Institutes of Health (NIH) analysis of growth and aging of the U.S. population. But new diagnostic tools and treatments could raise medical expenditures as high as $207 billion, assuming that the costs of new treatments increases 5 percent, said the researchers from the National Cancer Institute (NCI), part of the NIH. The analysis appears in the Journal of the National Cancer Institute. Recent trends reflect a 2 percent annual increase in medical costs in the initial and final phases of care, which would boost projected 2020 costs to $173 billion.Projec... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360984 Mon, 17 Jan 2011 20:00:00 +0100 4360984 http://www.medworm.com/index.php?rid=4360985&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhomeopathy-why-is-the-canadian-government-regulating-a-scam%2F2011.01.17 Regular readers of the Better Health blog are familiar with the shoddy science behind homeopathy (an outdated system of “medical” treatment that relies on water dilution and shaking to ‘”strengthen” the effects of drugs). But because homeopathic placebos have been marketed so successfully (even receiving paid endorsements from hockey teams), the Ontario government has decided to regulate homeopathic practices. In this terrific news exposé, reporters ask if it’s appropriate for the government to regulate health scams. In doing so, are they not lending credibility to modern-day snake oil? Check out these videos and let me know what you think. Is there a roll for government in regulating homeopathy? Part 1:   (more…) (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4360985 Mon, 17 Jan 2011 13:00:14 +0100 4360985 http://www.medworm.com/index.php?rid=4355716&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-patients-have-clinical-judgment%2F2011.01.16 I used to think they didn’t, but they do. Clinical judgment is the application of individual experience to the variables of a patient’s medical presentation. It’s the hard-worn skill of knowing what to do and how far to go in a particular situation. It’s having the confidence to do nothing. Clinical judgment is learned from seeing lots of sick people. Good clinical judgment is when the gifted capacity of reasoning intersects with experience. Some doctors have better judgment than others. Aristotle called this phronesis – or practical judgment. Patients have practical judgment. We often can tell when something’s amiss with our own body. Things feel different or look different. Taking action on these observations is how we exercise judgment as patients. Parents of chi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4355716 Sun, 16 Jan 2011 23:00:49 +0100 4355716 http://www.medworm.com/index.php?rid=4355718&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpsychiatric-diagnosis-and-the-dsm-5-controversy%2F2011.01.16 I’ve followed in bits and pieces — sometimes for Shrink Rap, sometimes because the issues fill my email inbox, sometimes because there’s no escape. Oh, and lots of the players have familiar names. In the December 27th issue of Wired magazine, Gary Greenberg writes a comprehensive article on the debates around the revision of the American Psychiatric Association’s (APA) upcoming revision of the Diagnostic and Statistical Manual (DSM) entitled “Inside the Battle to Define Mental Illness.” Do read it. Here’s an excerpt: I recently asked a former president of the APA how he used the DSM in his daily work. He told me his secretary had just asked him for a diagnosis on a patient he’d been seeing for a couple of months so that she could bill the insur... Better Health blogs http://www.medworm.com/rss/comments.php?id=4355718 Sun, 16 Jan 2011 17:00:00 +0100 4355718 http://www.medworm.com/index.php?rid=4352712&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-mobile-phones-improve-health-in-developing-countries%2F2011.01.15 The potential of mobile phones to improve health is most acutely visible in developing countries. iMedicalApps covered the recent mHealth Summit, where there were many inspiring demonstrations of how voice and simple text messages can have a profound effect on the health of those countries’ citizens. Jhpiego has successfully worked on these problems for three decades and was recently awarded a $100m grant. James Bon Tempo has extensive experience in this field and we are thrilled that he is sharing his insights with the readers of iMedicalApps. This is a guest post from James BonTempo. ********** Mobile Health In Developing Countries I am a user and an implementer of technology, not an inventor or developer, so my constraints, challenges and requirements are different than those of many... Better Health blogs http://www.medworm.com/rss/comments.php?id=4352712 Sat, 15 Jan 2011 18:00:40 +0100 4352712 http://www.medworm.com/index.php?rid=4352713&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-slippery-slope-of-anti-vaccine-complacency%2F2011.01.15 I got a package in the mail today: My very own (complimentary) copy of Paul Offit’s new book, “Deadly Choices; How the Anti-Vaccine Movement Threatens Us All.” Needless to say, I can’t wait to read it. Not coincidentally, Dr. Offit has been making the rounds of interviews in the wake of the book’s release. Although I haven’t heard any of them directly, I did see a reference to this NPR interview on the FaceBook page of an old friend, who quoted from it thusly: IRA FLATOW:  You write that some pediatricians will not see kids who are not vaccinated. Is that a good solution to the problem? DR. PAUL OFFIT: I don’t know what’s a good solution to that problem. And I feel tremendous sympathy for the clinician who’s in private practice. On the one hand, and my wife sort ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4352713 Sat, 15 Jan 2011 15:00:02 +0100 4352713 http://www.medworm.com/index.php?rid=4343129&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fglaucoma-testing-through-the-eyelid%2F2011.01.13 Intraocular pressure is usually measured by applying a force on the cornea using a tonometer. Although sufficiently accurate, tonometers are only used in ophthalmologist offices and so don’t measure intra-day pressures. They also fail with people post cataract surgery that have a thicker cornea. Researchers at University of Arizona have developed a new device that measures intraocular pressure through the eyelid. From the University of Arizona College of Engineering: The self-test instrument has been designed in Eniko Enikov’s lab at the UA College of Engineering. Gone are the eye drops and need for a sterilized sensor. In their place is an easy-to-use probe that gently rubs the eyelid and can be used at home. “You simply close your eye and rub the eyelid like you might c... Better Health blogs http://www.medworm.com/rss/comments.php?id=4343129 Thu, 13 Jan 2011 16:00:03 +0100 4343129 http://www.medworm.com/index.php?rid=4337934&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-doctors-and-patients-speak-different-languages%2F2011.01.12 I can’t say that I enjoy the patient encounter as much when it involves a translator. There’s just something about communicating through a third party that changes the experience. But there are some things you can do as a provider to bridge the language gap: Look. Even thought the translator is doing the talking, look at the patient just as if you are asking the question yourself. There’s a tendency to let the translator act as a surrogate with respect to eye contact and visual feedback. Smile. A smile doesn’t need translation. It conveys very clearly that have a sincere interest in making a connection. Touch. I never leave the exam room without some type of sincere physical contact. A firm handshake or a hand on the shoulder go a long way in closing the language barrier. Sa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337934 Wed, 12 Jan 2011 22:00:29 +0100 4337934 http://www.medworm.com/index.php?rid=4337937&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F%25e2%2580%259cjust-in-case%25e2%2580%259d-heart-tests-can-they-do-more-harm-than-good%2F2011.01.12 Here’s an important equation that all of us — doctors include — should know about healthcare, but don’t: More ≠ Better “More does not equal better” applies to diagnostic procedures, screening tests meant to identify problems before they appear, medications, dietary supplements, and just about every aspect of medicine. That scenario is spelled out in alarming detail in the Archives of Internal Medicine. Clinicians at the Cleveland Clinic describe the case of a 52-year-old woman who went to her community hospital because she had been having chest pain for two days. She wasn’t having symptoms of a heart attack, such as shortness of breath, unexplained nausea, or a cold sweat, and her electrocardiogram and other tests were fine. The woman’s doctors concluded that her ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337937 Wed, 12 Jan 2011 16:00:10 +0100 4337937 http://www.medworm.com/index.php?rid=4337938&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcontraceptive-failures-a-reality-check%2F2011.01.12 The media has been buzzing over recent reports of pregnancies occurring in women using Implanon, a single rod progestin-only contraceptive inserted under the skin of the upper arm and lasting for up to three years. The headlines make it sound horrifying: “Hundreds Become Pregnant Despite Contraceptive Implanon” and “British Pregnancy Scare in UK Implicates Implanon.” I love how terminology can make something so common sound so frightening. Actually, what happened was that 584 pregnancies occurred in Britain among about 1.3 million women using Implanon, for a failure rate of .04 percent. In other words, the method had an efficacy of over 99 percent. That’s a pretty effective contraceptive if you ask me. But it should have been better than that As good as it may seem, this failur... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337938 Wed, 12 Jan 2011 14:00:45 +0100 4337938 http://www.medworm.com/index.php?rid=4337939&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-repeal-how-would-it-affect-coverage-and-cost%2F2011.01.11 [Soon] the new GOP-controlled House of Representatives will be voting on and is expected to pass a bill to repeal the Affordable Care Act (ACA) – lock, stock, and barrel. There is virtually no chance the repeal bill will get through the Senate, though, which maintains a narrow Democratic majority, and President Obama would veto it if it did. But let’s say that the seemingly impossible happened, and the ACA was repealed. What would the impact be on healthcare coverage, costs, and the federal deficit? In a letter to Speaker John Boehner (R-OH), the Congressional Budget Office (CBO) released its preliminary estimates of the impact of repeal on the deficit, uninsured, and costs of care, and found that it would make the deficit worse, result in more uninsured persons, and higher premiu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337939 Tue, 11 Jan 2011 22:00:00 +0100 4337939 http://www.medworm.com/index.php?rid=4337942&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fknow-thy-calories-nutrition-labeling-guidelines-for-restaurants%2F2011.01.11 As part of the new healthcare legislation (Affordable Care Act), the FDA has now published its guidelines for restaurants to inform consumers of the calorie counts of food. It establishes requirements for nutrition labeling of standard menu items for chain restaurants and chain vending machine operators. This is important because Americans now consume an estimated one-third of their total calories from foods prepared outside the home. Consumers are generally unaware of the number of calories they consume from these foods, and being overweight or obese increases the risk of a number of diseases including heart disease, type 2 diabetes, stroke, and cancer. Here’s what the guidelines say: – Restaurants with 20 or more locations must disclose the number of calories in each stand... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337942 Tue, 11 Jan 2011 16:00:00 +0100 4337942 http://www.medworm.com/index.php?rid=4331011&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcesarean-section-6-ways-to-prevent-complications%2F2011.01.11 Although I’ve been a proponent for the prevention of medical errors for years and wrote a book to address those issues, I think my obstetrician-gynecologist (OB/GYN) colleagues are finally catching on. Dr. Patrick Duff of the University of Florida’s OB/GYN department wrote an article in the December issue of the journal Obstetrics & Gynecology that caught my attention. In his article, “A Simple Checklist for Preventing Major Complications Associated with Cesarean Delivery,” Duff outlines steps that OB/GYNs should take in order to reduce complications during and after a cesarean section. Duff patterns his list after Dr. Atul Gawande’s book, “The Checklist Manifesto: How to Get it Right,” which has set the standard regarding reducing complications after su... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331011 Tue, 11 Jan 2011 14:00:15 +0100 4331011 http://www.medworm.com/index.php?rid=4331012&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-patients-and-remote-third-parties%2F2011.01.10 From the ominously-titled book “New Rules” by Donald Berwick, M.D., and Troyen Brennan M.D.: “Today, this isolated relationship [between doctor and patient] is no longer tenable or possible. . . Traditional medical ethics, based on the doctor-patient dyad, must be reformulated to fit the new mold of the delivery of health care. . . The primary function of regulation in health care…is to constrain decentralized individualized decision making.” Unfortunately, Dr. Berwick’s straightforward formulation of the appropriate role of the individual physician in our reformed healthcare system is not isolated to thinkers of the Progressive persuasion. The notion that most clinical decisions can be usefully made by a centralized authority is attractive even to some conservatives. For examp... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331012 Mon, 10 Jan 2011 22:00:27 +0100 4331012 http://www.medworm.com/index.php?rid=4331013&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftired-surgeons-how-long-was-the-patient-asleep%2F2011.01.10 In a recent New England Journal of Medicine, a perspective piece on what to do with fatigued surgeons is generating debate. The issue of work-hour restrictions has been a controversial issue when it comes to doctors in training, something that I wrote about earlier in the year in USA Today. But once doctors graduate and practice in the real world, there are no rules. As summarized in the WSJ’s Health Blog, the perspective piece argues for more regulation for tired surgeons: … self-regulation is not sufficient. Instead, “we recommend that institutions implement policies to minimize the likelihood of sleep deprivation before a clinician performs elective surgery and to facilitate priority rescheduling of elective procedures when a clinician is sleep-deprived,” they write. For exampl... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331013 Mon, 10 Jan 2011 20:00:40 +0100 4331013 http://www.medworm.com/index.php?rid=4331014&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fbuzcooper.files.wordpress.com%2F2011%2F01%2Fmedpac-fig-2c.png MedPAC has released another report in which they have tried to explain variation in healthcare utilization among metropolitan statistical areas (MSAs), of which there are approximately 400. MSAs more-or-less correspond to Dartmouth’s 306 hospital referral regions (HRRs), and the conclusions reached by the Dartmouth folks and MedPAC tend to correspond. In commenting about MedPAC’s last report, issued in December 2009, I noted that the major variation was caused by high Medicare expenditures in seven southern states, where patients are poorer and sicker and use much more care.    In their new report, MedPAC went a step beyond measuring expenditures, which they adjusted for prices and other factors in their last report, to measuring the actual units of service, a far better way to ass... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331014 Mon, 10 Jan 2011 18:00:23 +0100 4331014 http://www.medworm.com/index.php?rid=4331015&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Frepealing-healthcare-reform-to-gain-campaign-ammunition%2F2011.01.10 Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate. But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal. Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. Hous... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331015 Mon, 10 Jan 2011 16:00:00 +0100 4331015 http://www.medworm.com/index.php?rid=4331016&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffirst-report-from-the-society-of-participatory-medicines-newly-appointed-public-policy-committee-chair-david-harlow%2F2011.01.10 In December, the Society for Participatory Medicine’s executive committee appointed health law attorney David Harlow to represent the Society in public policy matters. Regular readers of HealthBlawg::David Harlow’s Health Care Law Blog know what a patient-centered, participatory thinker David is. This is his first report. I am delighted to offer my first report as Public Policy Committee Chair for the Society of Participatory Medicine. I encourage all of you who are not yet Society members to join, and I encourage new and old members to consider volunteering to help with the wide range of public policy issues facing us today. Over the past couple of months, the Public Policy Committee has gotten its sea legs. We are beginning to add the Society’s voice to the national discourse on p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4331016 Mon, 10 Jan 2011 14:00:15 +0100 4331016 http://www.medworm.com/index.php?rid=4331278&cid=t_136248_180_f&fid=38612&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fpickthebrain%2FLYVv%2F%7E3%2FImwOCVvVcjk%2F In this article I’m going to show you the way I learned to meditate, based on research and the teachings of different gurus. Meditation is a pretty common subject these days As with many things that fall into popular use, its true meaning and purpose can become distorted. There are a lot of misconceptions out there about what exactly meditation is, and how one should do it. Common Misconceptions It’s strange that there is so much confusion, as it’s one of the simplest things you could ever do. First, meditation isn’t reflection. The whole point of meditation is transcendence of the mind and the need for self concepts, so critical thinking and any sort of analysis are by default out. Sitting in the lotus position or humming also have precious little to do with it, th... PickTheBrain | Motivation and Self Improvement blogs http://www.medworm.com/rss/comments.php?id=4331278 Mon, 10 Jan 2011 07:03:16 +0100 4331278 http://www.medworm.com/index.php?rid=4326900&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-patdown-diabetes-at-the-airport%2F2011.01.09 Last week we were at the airport to travel to Marco Island for the CWD Family Weekend. And we were NOT traveling light, by any stretch. Chris and I had our suitcases, our laptops, and my diabetes supplies (infusion sets, insulin, test strips, glucose tabs, etc.) stashed in a carry on. Oh, and we also had that giggly baby BSparl, plenty of clothes for her to spit up on, formula, bottles, wipes, diapers, water for mixing the formula, toys, Happy Baby puffs for snacks, her car seat, the car seat base, and the stroller. (Phew.) In addition to all the junk we were carrying, I was also wearing my Animas Ping and my Dexcom sensor (and carrying the receiver) — which made me a prime candidate for the airport opt-out search from a TSA employee, thanks to the fact that these devices are bett... Better Health blogs http://www.medworm.com/rss/comments.php?id=4326900 Sun, 09 Jan 2011 23:00:05 +0100 4326900 http://www.medworm.com/index.php?rid=4326901&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-musicians-brain-on-mri%2F2011.01.09 Dr. Charles Limb is an otolaryngologist, and he’s also on the faculty at the Peabody Conservatory of Music. Wanting to study creativity on the neurological level, he used fMRI to scan the brains of musicians while improvising along with them. Here he describes the experiment, including the building of an MRI-compatible electronic keyboard: Link @ TED… *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4326901 Sun, 09 Jan 2011 20:00:26 +0100 4326901 http://www.medworm.com/index.php?rid=4326902&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-energy-drink%2F2011.01.09 By Scott Gavura, BScPhm, MBA, RPh for Science-Based Medicine My stimulant of choice is coffee. I started drinking it in first-year university, and never looked back. A tiny four-cup coffee maker became my reliable companion right through graduate school. But since I stopped needing to drink a pot at a time, an entirely new category of products has appeared — the energy drink. Targeting students, athletes, and others seeking a mental or physical boost, energy drinks are now an enormous industry: From the first U.S. product sale in 1997, the market size was $4.8 billion by 2008, and continues to grow. (1) My precious coffee effectively has a single therapeutic ingredient, caffeine. Its pharmacology is well documented, and the physiologic effects are understood. The safety data isn’... Better Health blogs http://www.medworm.com/rss/comments.php?id=4326902 Sun, 09 Jan 2011 17:00:48 +0100 4326902 http://www.medworm.com/index.php?rid=4326903&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgetting-kids-to-eat-low-sugar-cereals%2F2011.01.09 Just about everybody agrees that kids should eat breakfast every day. Breakfast improves their overall nutrition and their performance in school, among other things. But how helpful can breakfast really be if it consists of cereal deluged in sugar? “Not very” is the answer. Thankfully, a new study by Jennifer Harris and colleagues at Yale suggests that kids are perfectly willing to consume low-sugar cereals instead, particularly if they can add a pinch of table sugar or fresh fruit to the mix. To evaluate kids’ willingness to eat low-sugar cereals, Harris’ team randomized 91 kids between the ages of five and 12 to two groups. Kids in the first group were offered low-sugar cereals like Cheerios, Corn Flakes, and Rice Krispies, which contain one to four grams of sugar per servin... Better Health blogs http://www.medworm.com/rss/comments.php?id=4326903 Sun, 09 Jan 2011 14:00:41 +0100 4326903 http://www.medworm.com/index.php?rid=4326904&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-interview-with-a-director-of-nursing%2F2011.01.08 “NurseExec” is the director of nursing (DON) at a 120-bed skilled nursing facility (SNF) that has a 50/50 mix of patients needing short-term rehab and long-term care. After working in the OR as a circulator nurse, she started out as a charge nurse in her current building, which entailed pushing a med cart and taking care of 20 patients. After nine months, she was promoted to Risk Manager and three years later became the DON. She starts her day at 7am by rounding on nursing units, consulting with unit managers on clinical issues, and dealing with grievances and employee issues. She checks in with the charge nurses and certified nursing assistants (CNAs), checks shower rooms and utility rooms. Then it’s off to Morning Standup with department heads, followed by clinical rounds with ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4326904 Sat, 08 Jan 2011 23:00:00 +0100 4326904 http://www.medworm.com/index.php?rid=4324794&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-a-bra-interact-with-a-pacemaker-or-defibrillator%2F2011.01.08 This comment [with a specific photo] was posted on my blog earlier: “I was reading one of your old posts about magnets and I was wondering if a magnetic front closure on a bra would be a problem? There’s a warning on the label but I know part of that is just due to liability. What about this bra that has a magnet clasp on the front? If the magnet hits right in between the breasts would it be close enough to the device that it could interfere? Also does having a magnet that close change the settings or turn off a defibrillator/pacemaker early? I’m sure most doctors would say just wear another bra but this bra in particular is very comfy! I’ve tried it on but not worn it for extended periods of time. Luckily this is one of the only major complaints I’ve had abo... Better Health blogs http://www.medworm.com/rss/comments.php?id=4324794 Sat, 08 Jan 2011 20:00:00 +0100 4324794 http://www.medworm.com/index.php?rid=4324795&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwinterize-your-mind-and-body%2F2011.01.08 This is a guest post from Dr. Jena Wider. ********** Winterize Your Mind And Body During the winter months, certain health issues may arise that women should have on their radar. From mental health issues like stress, depression and seasonal affective disorder (SAD), to physical concerns like skin care, the winter can certainly pack an extra punch. Depression peaks during the holiday season, affecting more than 17 million Americans, according to the National Mental Health Association. On average, women are more vulnerable to stress-related illnesses like depression and anxiety than men. One study, conducted by Pacific Health Laboratories, revealed that 44 percent of American women report feeling sad through the holidays compared to 34 percent of American men. “Depression of any kind ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4324795 Sat, 08 Jan 2011 17:00:17 +0100 4324795 http://www.medworm.com/index.php?rid=4322506&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdeath-why-are-we-so-afraid-of-it%2F2011.01.07 My cousin’s mother-in-law is in her late 90s. She had horrible osteoporosis and can barely move. She has little cognitive function left. She requires nearly 24-hour care and no one would even attempt to say she has any quality of life left. She told her son years ago that she was “ready to go,” and had had enough. And yet when I asked my cousin’s husband if his mother had any do-not-resuscitate orders, or had ever completed an advanced director  outlining her wishes of what kind of end-of-life care she wanted, he said no. His sister, he said, just wasn’t ready for that yet. So what, I asked, will you do when/if your mother gets pneumonia? Will you treat it with antibiotics? Will you put her on a respirator? If she is no longer able to eat, will you feed her t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4322506 Fri, 07 Jan 2011 22:00:00 +0100 4322506 http://www.medworm.com/index.php?rid=4322507&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpain-contracts-do-they-threaten-the-doctor-patient-relationship%2F2011.01.07 Doctors today are wary about treating chronic pain. One of the main worries is precipitating fatal opioid overdoses. Indeed, according to the CDC, and reported by American Medical News, “fatal opioid overdoses tripled to nearly 14,000 from 1999 to 2006 … [and] emergency department visits involving opioids more than doubled to nearly 306,000 between 2004 and 2008.” Requiring chronic pain patients to sign pain contracts is a way to mitigate this risk. But how does that affect the doctor-patient relationship? Indeed, a contract is an adversarial tool. Essentially, it states that a patient must comply with a strict set of rules in order to receive medications, including where and how often they obtain controlled substances, and may involve random drug testing. Break the contract and the ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4322507 Fri, 07 Jan 2011 20:00:11 +0100 4322507 http://www.medworm.com/index.php?rid=4322508&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysician-visibility-in-public-i-see-patients-and-they-see-me%2F2011.01.07 In the movie “The Sixth Sense,” there was that kid who saw dead people. I’m like that. But I see patients and their parents instead. They’re all around me. They’re watching at the grocery store when my kids act up. We meet during anniversary dinners, at Christmas Eve service, and on the treadmill at the Y. I bump into parents when buying personal effects and even during the early morning coffee run in my oldest sweats. I see patients. The follow-up dialog between the parents might go something like this: Dad: “Marge, don’t you think Billy’s colitis might be better managed by a doctor capable of pulling himself together?” Mom: “Don’t be ridiculous, Frank. DrV’s bedhead has nothing to do with his ability to care for Billy. And besides, I’ve heard tha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4322508 Fri, 07 Jan 2011 18:00:43 +0100 4322508 http://www.medworm.com/index.php?rid=4322509&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat%25e2%2580%2599s-wrong-it%25e2%2580%2599s-a-generic-drug-rip-off-thats-what%2F2011.01.07 Cute packaging and product placement in the checkout lane at Duane Reade will get you generic Tylenol for a price equivalent to $50 for 100 tabs, as opposed to $6 per 100 count in the usual package. *This blog post was originally published at tbtam* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4322509 Fri, 07 Jan 2011 16:00:26 +0100 4322509 http://www.medworm.com/index.php?rid=4322510&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Faverage-hourly-earnings-of-primary-care-relative-to-other-specialists-graph%2F2011.01.07 Here’s an interesting article, talking about stuff that’s not new to anyone who has read my blog for the last three years. The current relative value unit (RVU) system is a scam, perpetuated by a super-secretive group of subspecialists each  inflating their own worth for the benefit of themselves, at the expense of primary care. If you don’t understand what I’m talking about, first read about RVUs explained. Then come back and read this article put out by the National Institute for Health Care Management. It’s titled “Out of Whack: Pricing Distortions in the Medicare Physician Fee Schedule.“ In his essay, Dr. Robert Berenson shows how distorted primary care specialties are paid, relative to other specialties, in an all Medicare practice with t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4322510 Fri, 07 Jan 2011 14:00:00 +0100 4322510 http://www.medworm.com/index.php?rid=4318331&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcomparative-effectiveness-research-more-can-be-less%2F2011.01.06 Discussion About Comparative Effectiveness Research When the public turns its attention to medical effectiveness research, a discussion often follows about how this research might restrict access to new medical innovations. But this focus obscures the vital role that effectiveness research will play in evaluating current medical and surgical care. I am now slogging through chemotherapy for stomach cancer, probably the result of high doses of radiation for Hodgkin lymphoma in the early 1970s, which was the standard treatment until long-term side effects (heart problems, additional cancers) emerged in the late 80s. So I am especially attuned to the need for research that tracks the short and long-term effectiveness — and dangers — of treatments.  Choosing a surgeon this Septembe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318331 Thu, 06 Jan 2011 22:00:53 +0100 4318331 http://www.medworm.com/index.php?rid=4318332&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbad-science-and-the-gift-of-medical-skepticism%2F2011.01.06 Discover magazine had an article about Dr. Ben Goldacre, a British physician who writes for The Guardian, is the author of the new book “Bad Science: Quacks, Hacks, and Big Pharma Flacks,” and is considered a gift to skepticism. His column is also called “Bad Science,” and he recently gave a short and interesting talk about non-evidence-based medicine at the Pop!Tech conference held in Camden, Maine. Enjoy! Ben Goldacre Talks Bad Science from PopTech on Vimeo. *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4318332 Thu, 06 Jan 2011 20:00:52 +0100 4318332 http://www.medworm.com/index.php?rid=4318333&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-spending-slowest-growth-since-the-great-depression%2F2011.01.06 Healthcare spending grew in 2009 at its slowest rate since 1938, according to a report published in Health Affairs. The last time America saw such a slow growth rate on health spending it was still emerging from the Great Depression and hadn’t yet entered World War II. The most recent recession is also the cause for the health spending figures, according to the annual report, released by the Centers for Medicare and Medicaid Services. The report shows that the recession left a deeper impact than previous ones. Healthcare spending grew 4 percent to $2.5 trillion, outpacing the rest of the still recovering economy. Authors wrote that the recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capita... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318333 Thu, 06 Jan 2011 18:00:00 +0100 4318333 http://www.medworm.com/index.php?rid=4318334&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-autism-vaccine-fraud-the-difference-one-journalist-can-make%2F2011.01.06 The BMJ’s statement this week that the 1998 article by Andrew Wakefield and 12 others “linking MMR vaccine and autism was fraudulent” demonstrates what a difference one journalist can make. Journalist Brian Deer played a key role in uncovering and dismantling the Wakefield story. (Of course, others recently have said something similar about The Daily Show comedian Jon Stewart’s role in focusing on the health problems of 9/11 first responders.) CNN’s Anderson Cooper had a segment worth watching, including a new interview Cooper conducted with Wakefield via Skype: Unfortunately, journalism played a key role in promoting Wakefield’s claims. The “Respectful Insolence” blog referred to one journalist as “CBS’ resident anti-vaccine pro... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318334 Thu, 06 Jan 2011 16:00:16 +0100 4318334 http://www.medworm.com/index.php?rid=4318335&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdenying-the-obesity-epidemic%2F2011.01.06 It seems that for every established science there is an ideological group who is motivated to deny it. Denialism is a thriving pseudoscience and affects any issue with the slightest political or social implications. Sometimes, even easily verifiable facts can be denied, as people seem willing to make up their own facts as needed. Denialists have an easy job — to spread doubt and confusion. It is far easier to muddy the waters with subtle distortions and logical fallacies than it is to set the record straight. Even when every bit of misinformation is countered, the general public is often left with the sense that the topic is controversial or uncertain. If denial is in line with a group’s ideology, then even the suggestion of doubt may be enough to reject solid science. We see this ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318335 Thu, 06 Jan 2011 14:00:53 +0100 4318335 http://www.medworm.com/index.php?rid=4314004&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F7-3-10-foods-to-avoid-in-2011%2F2011.01.05 A patient reading a copy of Prevention in the waiting room brought to my attention an interesting article entitled “7 Foods That Should Never Cross Your Plate.” I would have to agree that these seven commonly eaten foods should be avoided, so I’ll rehash them here, along with three more of my own choosing to flesh out a New Year’s 7 + 3 = Top 10 list. The lead into the article implores the reader to recognize that “clean eating means choosing fruits, vegetables, and meats that are raised, grown, and sold with minimal processing.” Michael Pollan, the regarded author of The Omnivores Dilemma and In Defense of Food, puts it even more simply: “Eat food. Not too much. Mostly plants.” So here are the food items to avoid, in no particular order: 1) Canned Tomatoes – The resin t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314004 Thu, 06 Jan 2011 00:00:10 +0100 4314004 http://www.medworm.com/index.php?rid=4314005&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fon-the-value-of-open-mindedness%2F2011.01.05 Three recent sto­ries lead me to my open­ing topic for the year: The value of open-mindedness. This char­ac­ter­is­tic — a state of recep­tive­ness to new ideas — affects how we per­ceive and process infor­ma­tion. It’s a qual­ity I look for in my doc­tors, and which I admire espe­cially in older people. Piece #1 — On the brain’s matu­rity, flex­i­bil­ity and “cog­ni­tive fitness” For the first piece, I’ll note a Dec 31 op-ed piece that appeared in the New York Times: This Year, Change Your Mind, by Dr. Oliver Sacks, the neu­rol­o­gist and author. In this thought­ful essay, he con­sid­ers the adult brain’s “mys­te­ri­ous and extra­or­di­nary” power to adapt and grow: “I have seen hun­dreds of patients with var­i­ous deficits &#8212... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314005 Wed, 05 Jan 2011 22:00:57 +0100 4314005 http://www.medworm.com/index.php?rid=4314006&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhenrietta-lacks-and-her-immortal-cells%2F2011.01.05 If you like science, true history, and an engaging story, pick up the new book by journalist Rebecca Skloot, “The Immortal Life of Henrietta Lacks” and prepare for a great read. I knew nothing about the young black woman whose cells were taken back in 1951 by a scientist at Johns Hopkins Hospital and how those cells have revolutionized modern cell biology and research. The HeLa (named after HEnrietta LAcks) cells were taken as she lay dying on the “colored” ward at Johns Hopkins Hospital of aggressive cervical cancer at age 30. Everyone who studies basic cell biology has heard of HeLa cells because they were the first human cell line to be successfully grown in culture and they are alive today. HeLa cells were sent to researchers all across the globe and have been... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314006 Wed, 05 Jan 2011 20:00:00 +0100 4314006 http://www.medworm.com/index.php?rid=4314007&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-year-begins-with-a-baby-boom%2F2011.01.05 On January 1, Kathleen Casey-Kirschling became the first of the baby-boom generation to qualify for Medicare. She’s hardly alone: The baby-boom generation will cause enrollment in Medicare to soar. According to the Kaiser Family Foundation, Medicare enrollment will increase from 47 million today to 64 million in 2020 to 80 million people by 2030. At the same time, the ratio of workers paying into the program to support each Medicare enrollee will drop from 3.4 (2010) to 2.8 (2020) and then to 2.3 workers per beneficiary in 2030, denying the program the tax revenue needed to sustain it. What happens then? Well, the President and Congress would have a dismal menu of political and policy choices. They could impose huge tax increases, inflicting great harm on working families and the economy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314007 Wed, 05 Jan 2011 18:00:00 +0100 4314007 http://www.medworm.com/index.php?rid=4314008&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fliposuction-related-death-and-finding-a-safe-doctor%2F2011.01.05 From the Chicago Tribune: A 35-year-old woman who wanted to resculpt herself for the new year with liposuction and a buttocks enhancement is dead from apparent complications of plastic surgery, her husband and lawyer said Thursday. Miami customer service representative Lidvian Zelaya died Monday, hours after the operation began at Strax Rejuvenation and Aesthetics Institute, a busy cosmetic surgery practice in Lauderhill. Zelaya went to Strax to have fat suctioned from her back and belly, and to have the material injected into her backside, family representatives said. She chose Strax because she got a good deal. Aronfeld said the operation was to be done by Dr. Roger L. Gordon. He was disciplined by the state in connection with two plastic surgery deaths in 2004. This is getting ridiculou... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314008 Wed, 05 Jan 2011 16:00:26 +0100 4314008 http://www.medworm.com/index.php?rid=4314009&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fi-smell-health-trouble%2F2011.01.05 I was surfing around the Net one day and I found this article about scientists who are creating a machine that will detect acetone in someone’s breath. Acetone can be a sign that someone suffers from diabetes, so in theory this machine could use scent to diagnose this disease. That story brought to mind other stories I’ve heard about people using dogs to sniff out cancer in people. According to this article: “The results of the study showed that dogs can detect breast and lung cancer with sensitivity and specificity between 88% and 97%. The high accuracy persisted even after results were adjusted to take into account whether the lung cancer patients were currently smokers. Moreover, the study also confirmed that the trained dogs could even detect the early stages of lung ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314009 Wed, 05 Jan 2011 14:00:00 +0100 4314009 http://www.medworm.com/index.php?rid=4309607&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftext-to-braille-conversion-via-touch-sensitive-thimble%2F2011.01.04 While Braille can give the blind the ability to read, much of the text one encounters is not available in Braille (and our increasing dependence on touch-screen smartphones isn’t helping.) Two students at the University of Washington hope to solve this problem with their concept device, which they have termed the “Thimble.” The Thimble contains a fingertip camera and an electro-tactile grid which can read text and convert it to touch-sensitive Braille. The device can also interface with a user’s smartphone via Bluetooth for reading online content. Source: “Thimble”: Another smartphone-enabled concept for the visually impaired (Hat Tip: Engadget) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4309607 Tue, 04 Jan 2011 22:00:55 +0100 4309607 http://www.medworm.com/index.php?rid=4309608&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpersonalized-medicine-a-2011-resolution-for-you%2F2011.01.04 You are an individual right? To your mom and dad you are/were like no other. Hopefully your family and friends continue to see you as one-of-a-kind. Had you considered your doctor should see you that way too? Not as yet another one with diabetes, or heart disease, or cancer, but as a singular human being with biology that may be different from even the next person through the door with the same diagnosis. This is the age of “personalized medicine” and it will accelerate in 2011. It is our responsibility as patients to ensure the power of this concept is leveraged for us each time we interact with the healthcare system. This is especially true as we manage a serious chronic condition or a cancer. Now, in research and in clinical practice there are refined tests to determine what our spe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309608 Tue, 04 Jan 2011 19:00:47 +0100 4309608 http://www.medworm.com/index.php?rid=4309609&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbreast-implants-a-geographical-comparison%2F2011.01.04 This article (full reference below, free access) came to my attention via MDLinx. It was interesting to read. The conclusion verified my expectations rather than surprised me. The authors conducted a retrospective review of patient demographics and implant information from three university settings: Kelowna (British Columbia, Canada), Loma Linda (California, USA), and Temple (Texas, USA). Each cohort included 100 consecutive breast augmentation cases. Characteristics analyzed included age, height, weight, BME, parity, and average implant volume.  When considering the 300 as one cohort, the average age was 34 years with a height of 163 cm (5’4”), weight of 58.1 (127.8 lb) and parity of 1.7 . The average implant size was 370 ml. (more…) *This blog post was originally p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309609 Tue, 04 Jan 2011 16:00:00 +0100 4309609 http://www.medworm.com/index.php?rid=4309610&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftop-10-health-stories-of-2010%2F2011.01.04 1. Health care reform How could the health care reform legislation that President Barack Obama signed into law on March 23, 2010, not be the #1 story of the year?  Whether you are for or against it, the Patient Protection and Affordable Care Act is nothing if not ambitious, and if implemented, it will fundamentally alter how American health care is financed and perhaps delivered.  The law is designed to patch holes in the health insurance system and extend coverage to 32 million Americans by 2019 while also reining in health care spending, which now accounts for more than 17% of the country’s gross domestic product. The biggest changes aren’t scheduled to occur until 2014, when most people will be required to have health insurance or pay a penalty (the so-called indiv... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309610 Tue, 04 Jan 2011 14:00:49 +0100 4309610 http://www.medworm.com/index.php?rid=4309611&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Falzheimers-disease-to-test-or-not-to-test%2F2011.01.03 The medical profession’s ability to diagnose far exceeds its ability to effectively treat the conditions discovered. Consider arthritis, Parkinson’s disease, irritable bowel syndrome, strokes, emphysema, and many cancers. When a physician orders a diagnostic test, ideally it should be to answer a specific question, rather than a buckshot approach. A chest X-ray is not ordered because a patient has a cough. It should be done because the test has a reasonable chance of yielding information that would change the physician’s advice. If the doctor was going to prescribe an antibiotic anyway, then why order the chest X-ray? Physicians and patients should ask before a test is performed if the information is likely to change the medical management. In other words, is a test being ordered bec... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309611 Mon, 03 Jan 2011 22:00:00 +0100 4309611 http://www.medworm.com/index.php?rid=4309612&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmaking-2011-meaningful%2F2011.01.03 Today, $27 billion in incentives begin for using electronic medical records, as office- and hospital-based providers begin to register for meaningful use criteria. Providers must use a certified system according to Centers for Medicare and Medicaid meaningful-use guidelines for 90 consecutive days within the first year of the program to qualify. Eligible professionals can receive up to $44,000 over five years under the program. There’s an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area. To get the most money, Medicare-eligible professionals must begin by 2012. By 2015, Medicare-eligible professionals and hospitals that do not demonstrate meaningful use get punished. (more…) *This blog post was originally publis... Better Health blogs http://www.medworm.com/rss/comments.php?id=4309612 Mon, 03 Jan 2011 20:00:00 +0100 4309612 http://www.medworm.com/index.php?rid=4304875&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffalse-positives-in-medical-tests-how-they-can-kill-patients%2F2011.01.03 I’ve written in the past that more medicine and tests do not necessarily reflect better care. There is no test that is 100 percent specific or sensitive. That means tests may be positive, when, in fact, there is no disease (“false positive”), or tests may be negative in the presence of disease (“false negative”). It’s the latter that often gets the most media attention, often trumpeted as missed diagnoses. But false positives can be just as dangerous. Consider this frightening case report from the Archives of Internal Medicine: A 52-year-old woman presented to a community hospital with atypical chest pain. Her low-density lipoprotein cholesterol and high-sensitivity C-reactive protein levels were not elevated. She underwent cardiac computed tomography angiography, which showed... Better Health blogs http://www.medworm.com/rss/comments.php?id=4304875 Mon, 03 Jan 2011 18:00:49 +0100 4304875 http://www.medworm.com/index.php?rid=4304876&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-secret-to-the-virginia-healthcare-decision%2F2011.01.03 Unconstitutional? How can the mandate to buy health insurance be unconstitutional? It must be some kind of misguided resistance to progressivism. Or maybe it’s someone finally taking a stand against a power-grabbing government program. But it’s actually about something else entirely. And if you don’t know what it is, you won’t understand why the Virginia court ruled the way it did. Here’s the secret: The U.S. Constitution grants to the federal government certain powers. These are things like raising an army, controlling currency and establishing courts. It also gives it the power to regulate interstate commerce, through something called the “Commerce Clause.” Everything else is the domain of the states. Notice that the Commerce Clause only gives the federal government po... Better Health blogs http://www.medworm.com/rss/comments.php?id=4304876 Mon, 03 Jan 2011 16:00:08 +0100 4304876 http://www.medworm.com/index.php?rid=4304877&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-best-book-on-health-care-reform%2F2011.01.03 The best book on health care reform — or surviving it — is the “The Innovator’s Prescription: A Disruptive Solution for Health Care.” The decade worth of research spent understanding, studying, and ultimately offering solutions to make the health care system more accessible, higher quality, and affordable is clear. Unlike other books, the authors, respected Harvard Business School (HBS) professor Clayton Christensen, Jerome Grossman, a doctor who also was the Director of Health Care Delivery Policy Program at Harvard Kennedy School, and Jason Hwang, another doctor and graduate of the MBA program at HBS, avoid the traps the plague most other solutions by taking a completely different perspective by looking at other industries where products and services offere... Better Health blogs http://www.medworm.com/rss/comments.php?id=4304877 Mon, 03 Jan 2011 14:00:00 +0100 4304877 http://www.medworm.com/index.php?rid=4304878&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-cancer-hits-a-doctors-home%2F2011.01.02 This year has been a weird one for me and cancer. In the ER, we see cancer patients pretty infrequently. The occasional chemotherapy with fever, but that’s about it. I think the oncologists try hard to keep the patients out of the ER — to everybody’s benefit. But this year, I’ve had a weird rash of cases where I’ve made primary diagnoses of cancer in the ER — several times over and over and over again. In ten years I don’t think I’ve made as many cancer diagnoses as I have this year alone. Just very strange. Unfortunately, it came home to roost. My wife was diagnosed with breast cancer last week. (more…) *This blog post was originally published at Movin' Meat* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4304878 Sun, 02 Jan 2011 22:00:00 +0100 4304878 http://www.medworm.com/index.php?rid=4304879&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffda-set-to-approve-new-anti-obesity-drug%2F2011.01.02 The FDA has been tough on diet drugs of late. Three years ago it scuttled an attempt to get the European diet drug rimonabant approved for use in the U.S. More recently it rejected, at least temporarily, applications for Qnexa and Lorcaserin. But that trend may have been reversed last week, when an advisory committee set the stage for possible FDA approval of Orexigen’s investigational diet drug, Contrave. By a 13-7 vote, the committee said in essence that the somewhat modest beneficial effects of the drug outweighed its tendency to increase blood pressure. The FDA will make final decision on the matter by the end of January. It is not required to follow the advice of its advisory committees, but as was the case for the three diet drugs mentioned above,  it usually does. (more…... Better Health blogs http://www.medworm.com/rss/comments.php?id=4304879 Sun, 02 Jan 2011 19:00:19 +0100 4304879 http://www.medworm.com/index.php?rid=4304880&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftwo-docs-whove-passed-they-mightve-been-social-media-giants%2F2011.01.02 This year I learned about the death of two physicians that were pretty important to me. The first was my pathology teacher, Dr. Guido Majno. In addition to being a tremendously kind and curious person, he and his wife wrote the best textbook I’ve ever read. The second death was that of my pediatrician growing up, Dr. Thomas Peebles. Funny, although he followed me from birth to high school, my family never knew about his incredible research background. We learned it in the many obituaries. It’s worth reflecting on their accomplishments and the manner in which they conducted their lives and practice — especially in this era, when doctors are encouraged to develop their social media presence and be proactive about online reviews. Would they have used these new tools? Would ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4304880 Sun, 02 Jan 2011 16:00:00 +0100 4304880 http://www.medworm.com/index.php?rid=4302857&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhealthcare-pr-puffery-a-year-end-review%2F2011.01.01 Healthcare journalists are buried under a mountain of public relations material sent to them every day of every week of every month. I don’t even work in a traditional news setting, yet I’ve made it onto the distribution lists of countless PR people. The picture on the left shows a pile of video news releases sent to one TV health news reporter over a relatively short time span. Here’s my year end look at just some of what was sent to me this year. Imagine what the New York Times, USA Today, the TV networks, and others receive. I get countless emails from PR people offering interviews with their experts on: • Seasonal Affective Disorder (SAD) — including an offer of an interview with a “celebrity trainer” who claims to have trained Julia Roberts, Cindy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4302857 Sat, 01 Jan 2011 23:00:41 +0100 4302857 http://www.medworm.com/index.php?rid=4302858&cid=t_136248_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fglobal-health-communication-the-top-10-in-2010%2F2011.01.01 From Blog 4 Global Health — an “interactive blog from the Global Health Council’s Policy, Research and Advocacy team” — here’s The Top 10 in 2010 Global Health Communication. An excerpt: If global health communication was characterized by anything in 2010, it was the rise of Twitter and other social media among non-profit organizations as a way of bypassing increasingly irrelevant traditional media and taking their messages directly to their target groups. From the Global Health Council, we saw more and more of our members — large and small — embracing new media like blogging, micro-blogging and social networks like Facebook. At the year’s last meeting of our Global Health Communicators Working Group in November, I asked for a show of hands of those w... Better Health blogs http://www.medworm.com/rss/comments.php?id=4302858 Sat, 01 Jan 2011 20:00:28 +0100 4302858